Nursing Elites

1. The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:

• A. Immediately before swimming
• B. 15 minutes before exposure to the sun
• C. Immediately before exposure to the sun
• D. At least 30 minutes before exposure to the sun

Correct answer: D

Rationale: Chemical sunscreens are most effective when applied at least 30 minutes before exposure to the sun to allow them to penetrate the skin and provide optimal protection. Applying sunscreen immediately before swimming (Choice A) or immediately before exposure to the sun (Choice C) may not provide sufficient time for the sunscreen to be absorbed and offer proper protection. Applying sunscreen 15 minutes before sun exposure (Choice B) is also not ideal as it may not allow enough time for the sunscreen to work effectively. Therefore, the correct answer is to apply chemical sunscreen at least 30 minutes before exposure to the sun to ensure it can be absorbed and offer the intended protection. It is important to reapply sunscreen after swimming or sweating to maintain its effectiveness.

2. A client has been prescribed cyclosporine (Sandimmune). Which food item should the client avoid based on the medication's interaction?

• A. Red meats
• B. Orange juice
• C. Grapefruit juice
• D. Green, leafy vegetables

Correct answer: C

Rationale: Grapefruit juice should be avoided when taking cyclosporine because it inhibits the metabolism of the medication, leading to increased blood levels and a higher risk of toxicity. It is important for the client to follow this dietary instruction to ensure the safe and effective use of cyclosporine.

3. A client is receiving intravenous heparin for a deep vein thrombosis. The healthcare provider should monitor the client for which of the following potential complications?

• A. Hypertension
• B. Tachycardia
• C. Bleeding
• D. Hyperkalemia

Correct answer: C

Rationale: Heparin is an anticoagulant, so the primary potential complication is bleeding. The healthcare provider should monitor the client for signs of bleeding, such as bruising, hematuria, and gastrointestinal bleeding. Hypertension, tachycardia, and hyperkalemia are not direct complications of heparin therapy. Therefore, the correct answer is bleeding, as it is the most significant risk associated with heparin administration.

4. A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse instruct the client to report to the healthcare provider?

• A. Dizziness
• B. Constipation
• C. Peripheral edema
• D. Dry cough

Correct answer: C

Rationale: The correct answer is C, 'Peripheral edema.' Amlodipine (Norvasc) can cause peripheral edema, which is an accumulation of fluid in the extremities and should be reported to the healthcare provider. Dizziness and constipation are possible side effects of amlodipine but are generally less concerning. Dry cough is more commonly associated with ACE inhibitors, not calcium channel blockers like amlodipine.

5. Which laboratory test should the nurse monitor to determine the effectiveness of heparin therapy for a client with deep vein thrombosis?

• A. Platelet count
• B. Prothrombin time (PT)
• C. Activated partial thromboplastin time (aPTT)
• D. Hemoglobin and hematocrit

Correct answer: C

Rationale: The activated partial thromboplastin time (aPTT) is the specific laboratory test used to monitor the effectiveness of heparin therapy in patients with deep vein thrombosis. It measures the time it takes for blood to clot and is crucial in assessing the therapeutic range of heparin. Platelet count, prothrombin time (PT), and hemoglobin and hematocrit levels are important parameters in assessing coagulation and blood status but do not directly indicate the effectiveness of heparin therapy.

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