Nursing Elites

1. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: An adverse effect of prochlorperazine is acute dystonia, which is evidenced by spasms of the muscles in the face, neck, and tongue. Diphenhydramine is used to suppress extrapyramidal effects of prochlorperazine, making it the most appropriate choice to address the client's spasms. Fomepizole is used in methanol or ethylene glycol poisoning, not for acute dystonia. Naloxone is an opioid antagonist used for opioid overdose, not for acute dystonia. Phytonadione is vitamin K, used for the reversal of warfarin, not for acute dystonia.

2. A client is prescribed Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?

• A. Dry mouth
• B. Hypertension
• C. Excessive perspiration
• D. Fecal impaction

Correct answer: C

Rationale: Bethanechol is a muscarinic agonist, which stimulates muscarinic receptors. Activation of these receptors can lead to increased sweating (excessive perspiration) as a manifestation of muscarinic stimulation. Options A, B, and D are not typically associated with muscarinic stimulation. Dry mouth is a common side effect of anticholinergic medications, hypertension is not a common manifestation of muscarinic stimulation, and fecal impaction is not directly related to muscarinic receptor activation.

3. When teaching a client with a prescription for Vancomycin, which instruction should the nurse include?

• A. Expect red man syndrome during treatment.
• B. Take the medication with a full glass of water.
• C. Increase your intake of potassium-rich foods.
• D. Monitor for hearing loss while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Vancomycin is known to cause ototoxicity, which can result in hearing loss. Therefore, it is important for clients to monitor for any changes in their hearing while taking this medication and promptly report any issues to their healthcare provider for further evaluation and management. Choices A, B, and C are incorrect because red man syndrome is associated with rapid infusion of Vancomycin, not a common side effect during treatment; taking the medication with a full glass of water is a general instruction for many medications but not specific to Vancomycin; and increasing potassium-rich foods is not directly related to Vancomycin therapy.

4. A healthcare professional is caring for four clients who have Peptic Ulcer Disease. The healthcare professional should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor and potentially lead to harm to the fetus. Therefore, it should not be used in pregnant clients due to its uterotonic effects. For clients with osteoarthritis, kidney stone, or urinary tract infection, Misoprostol is not contraindicated specifically for these conditions.

5. When using Nitroglycerine (transdermal), how many hours should you be nitrate-free each day?

• A. 1-2 hours
• B. 5-10 hours
• C. 3-4 hours
• D. 10-12 hours

Correct answer: D

Rationale: When using Nitroglycerine (transdermal), it should be applied for 10-12 hours per day to ensure its effectiveness. A nitrate-free period within the day is essential to prevent the development of tolerance to the medication.

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