Nursing Elites

1. What action should the healthcare provider take to reduce the risk of vesicant extravasation in a client receiving intravenous chemotherapy?

• A. Administer an antiemetic before starting the chemotherapy.
• B. Instruct the client to drink plenty of fluids during the treatment.
• C. Keep the head of the bed elevated until the treatment is completed.
• D. Monitor the client's intravenous site hourly during the treatment.

Correct answer: D

Rationale: Monitoring the intravenous site hourly is essential to identify early signs of extravasation, such as swelling or pain, which can help prevent tissue damage. Prompt detection allows for immediate intervention, minimizing the risk of serious complications associated with vesicant extravasation.

2. A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?

• A. Increase cardiac output
• B. Reduce fluid retention
• C. Decrease heart rate
• D. Lower blood pressure

Correct answer: C

Rationale: Carvedilol, a beta-blocker, is primarily prescribed in patients with chronic heart failure to decrease heart rate and reduce the workload on the heart. By lowering the heart rate, carvedilol helps the heart function more efficiently and improves symptoms in patients with heart failure.

3. Your patient has an order to receive Levothyroxine Sodium 75 mcg daily IV. You have a vial containing 100 mcg available from the pharmacy. According to the package insert, 5 mL of 0.9% sodium chloride is needed to reconstitute. You add the appropriate amount of sodium chloride to the vial. How many mcg of medication are in 1 mL of the vial?

• A. 20 mcg
• B. 15 mcg
• C. 25 mcg
• D. 30 mcg

Correct answer: A

Rationale: After reconstitution, the concentration of Levothyroxine Sodium in the vial is 100 mcg in 5 mL, which equals 20 mcg/mL. Therefore, in 1 mL of the vial, there are 20 mcg of medication.

4. A 48-year-old woman presents with fatigue, pruritus, and jaundice. She has a history of ulcerative colitis. Laboratory tests reveal elevated bilirubin and alkaline phosphatase. What is the most likely diagnosis?

• A. Hepatitis B
• B. Primary biliary cirrhosis
• C. Primary sclerosing cholangitis
• D. Autoimmune hepatitis

Correct answer: C

Rationale: The combination of symptoms (fatigue, pruritus, jaundice) along with a history of ulcerative colitis and elevated bilirubin and alkaline phosphatase levels suggests primary sclerosing cholangitis. Primary sclerosing cholangitis is commonly associated with inflammatory bowel disease, such as ulcerative colitis. It is characterized by inflammation and fibrosis of the bile ducts, leading to cholestasis and elevated alkaline phosphatase and bilirubin levels.

5. A client with Addison's disease is being treated with fludrocortisone (Florinef). Which electrolyte imbalance should the nurse monitor for?

• A. Hyperkalemia.
• B. Hyponatremia.
• C. Hypernatremia.
• D. Hypocalcemia.

Correct answer: C

Rationale: Fludrocortisone, such as Florinef, is a mineralocorticoid that promotes sodium retention and potassium excretion, which can lead to hypernatremia. Therefore, the nurse should closely monitor for hypernatremia when a client with Addison's disease is being treated with fludrocortisone. Hyperkalemia (Choice A) is incorrect because fludrocortisone promotes potassium excretion, leading to hypokalemia rather than hyperkalemia. Hyponatremia (Choice B) is incorrect as fludrocortisone promotes sodium retention. Hypocalcemia (Choice D) is unrelated to the action of fludrocortisone.

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