Nursing Elites

1. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and osteoporosis are conditions where estrogen therapy may actually be indicated. Dysfunctional uterine bleeding is another condition where estrogen therapy can be used to help regulate menstrual bleeding.

2. A client who takes Chlorpromazine for the treatment of Schizophrenia is due for a follow-up assessment. The nurse should expect the greatest improvement in which of the following manifestations? (Select all that apply.)

• A. Disorganized speech.
• B. Bizarre behavior.
• C. Impaired social interactions.
• D. Hallucinations.

Correct answer: A

Rationale: When a client takes a conventional antipsychotic medication like chlorpromazine, the greatest improvement is typically seen in positive symptoms such as disorganized speech. These medications are more effective in managing positive symptoms like disorganized speech rather than negative symptoms like impaired social interactions or hallucinations. Therefore, the nurse should anticipate improvement in disorganized speech as a positive response to chlorpromazine treatment.

3. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.

4. What is the action of Nitroglycerin?

• A. Dilates the Bronchi
• B. Reduces Blood Glucose
• C. Reduces Nausea
• D. Dilates Coronary Arteries

Correct answer: D

Rationale: Nitroglycerin acts by dilating the coronary arteries, leading to increased blood flow and oxygen supply to the heart. This helps in relieving angina symptoms by reducing the heart's workload and improving blood supply to the myocardium. Choices A, B, and C are incorrect because Nitroglycerin's primary action is not related to dilating bronchi, reducing blood glucose, or reducing nausea.

5. A client with active pulmonary tuberculosis (TB) is to be started on intravenous rifampin therapy. The client should be informed by the nurse that this medication can cause which of the following adverse effects?

• A. Constipation
• B. Black-colored stools
• C. Staining of teeth
• D. Body secretions turning a red-orange color

Correct answer: D

Rationale: The correct answer is D: Body secretions turning a red-orange color. Rifampin is known to cause body secretions, such as urine, sweat, tears, and sputum, to turn a harmless red-orange color. This is a common and expected side effect of rifampin therapy. Choices A, B, and C are incorrect. Constipation is not a common adverse effect of rifampin. Black-colored stools and staining of teeth are not associated with rifampin therapy. It is important for the nurse to educate the client about the harmless red-orange discoloration that may occur with this medication.

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