Nursing Elites

1. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.

2. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

3. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

4. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: Corrected Rationale: Enalapril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. The nurse should closely monitor the client for this and instruct them to report it to the healthcare provider if it occurs. Choices B, C, and D are incorrect as weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

5. Which of the following is not an effect of the drug isoflurane?

• A. Elevated lipid levels
• B. Nausea
• C. Increased blood flow to the brain
• D. Decreased respiratory function

Correct answer: A

Rationale: Isoflurane is not known to cause elevated lipid levels. Common effects of isoflurane include nausea, increased blood flow to the brain, and decreased respiratory function. Elevated lipid levels are not typically associated with the administration of isoflurane, making choice A the correct answer.

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