Nursing Elites

1. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

2. A client is to receive Tetracaine prior to a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

• A. Keep the client NPO until the pharyngeal response returns.
• B. Monitor the insertion site for a hematoma.
• C. Palpate the bladder to detect urinary retention.
• D. Maintain the client on bed rest for 12 hours following the procedure.

Correct answer: A

Rationale: The correct action the nurse should include in the plan of care is to keep the client NPO until the pharyngeal response returns. This is important to prevent aspiration until the client's normal pharyngeal sensation is restored, typically within about 1 hour after the procedure. Monitoring the insertion site for a hematoma, palpating the bladder, and maintaining the client on bed rest are not directly related to the administration of Tetracaine prior to a Bronchoscopy. Therefore, these actions are not necessary in the immediate post-procedure care of a client receiving Tetracaine for a Bronchoscopy.

3. While teaching a client starting therapy with rituximab, which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The correct answer is B: Fever. The nurse should instruct the client to report fever as it can be an indication of an infection, which is a potential complication of rituximab therapy. Monitoring for fever is crucial to promptly address any signs of infection and ensure the client's safety during treatment. Choices A, C, and D are not typically associated with rituximab therapy and are less likely to be directly related to a serious complication requiring immediate attention.

4. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of this medication. Verapamil is a calcium channel blocker used to treat hypertension, and dietary fiber helps maintain bowel regularity and prevent constipation that may occur as a side effect of the medication.

5. Before administering lithium to a client with bipolar disorder who has been taking the medication for 1 year, the nurse should check to see that which of the following tests has been completed?

• A. Thyroid hormone assay
• B. Liver function tests
• C. Erythrocyte sedimentation rate
• D. Brain natriuretic peptide

Correct answer: A

Rationale: The correct answer is to check the thyroid hormone assay. Long-term lithium use can result in thyroid dysfunction, making it crucial to monitor the client's thyroid function regularly to detect any abnormalities early and prevent potential complications. Liver function tests (choice B) are not specifically associated with lithium therapy. Erythrocyte sedimentation rate (choice C) is a nonspecific test for inflammation and not directly related to lithium therapy. Brain natriuretic peptide (choice D) is a test used to diagnose heart failure and is not relevant to monitoring lithium therapy.

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