Nursing Elites

1. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

2. A client has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a non-hairy area.
• B. Change the patch every 72 hours.
• C. Avoid exposure to heat sources.
• D. Do not cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction the nurse should include for a client using a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, potentially causing an overdose. Instructing the client to avoid heat sources is crucial to ensure their safety and the effectiveness of the medication. Choices A, B, and D are incorrect because applying the patch to a non-hairy area, changing it every 72 hours, and not cutting the patch are general guidelines for using transdermal patches but do not specifically address the unique risks associated with Fentanyl patches.

3. A healthcare professional is educating a client who has a new prescription for warfarin. Which of the following statements should the healthcare professional include?

• A. Avoid foods high in vitamin K.
• B. Report any signs of bleeding to your healthcare provider.
• C. Use a soft toothbrush to prevent gum bleeding.
• D. Use an electric razor to prevent cuts.

Correct answer: B

Rationale: The correct statement that the healthcare professional should include when educating a client prescribed warfarin is to report any signs of bleeding to their healthcare provider. Bleeding can indicate excessive anticoagulation, which is a serious side effect of warfarin. Prompt reporting of bleeding symptoms is crucial to prevent complications. Choices A, C, and D are incorrect. While avoiding foods high in vitamin K may be important when taking warfarin due to its interaction with the medication, it is not the priority over reporting signs of bleeding. Using a soft toothbrush and electric razor are general precautions for individuals on anticoagulants but are not as critical as reporting bleeding symptoms.

4. A client with Graves' disease is being educated by a nurse about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heartbeat.
• D. Propranolol promotes a decrease of thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that is commonly used in Graves' disease to decrease symptoms such as tremors and fast heart rate. Choice A is incorrect because Propranolol does not increase blood flow to the thyroid gland. Choice B is incorrect as Propranolol is not used to prevent excess glucose in the blood. Choice D is also incorrect as Propranolol does not directly decrease thyroid hormone levels in the body.

5. A healthcare professional is preparing to administer morphine 4 mg IV to a client. Available is morphine 10 mg/mL. How many mL should the healthcare professional administer?

• A. 0.2 mL
• B. 0.4 mL
• C. 0.6 mL
• D. 0.8 mL

Correct answer: B

Rationale: To administer 4 mg from a solution of 10 mg/mL, the healthcare professional should administer 0.4 mL. The calculation is done by dividing the desired dose (4 mg) by the concentration of the solution (10 mg/mL), which equals 0.4 mL. Choice A (0.2 mL) is incorrect because it is half of the correct calculation. Choice C (0.6 mL) is incorrect because it is 50% more than the correct calculation. Choice D (0.8 mL) is incorrect because it exceeds the correct calculation.

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