Nursing Elites

1. A client with schizophrenia is being taught strategies to cope with anticholinergic effects of Fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: Chewing sugarless gum is an effective strategy to manage dry mouth, a common anticholinergic effect of Fluphenazine. By stimulating saliva production, sugarless gum helps to moisten the mouth and alleviate the discomfort associated with dryness. This intervention can improve the client's oral health and overall comfort while taking the medication. The other options are not directly related to alleviating anticholinergic effects. Taking the medication in the morning to prevent insomnia does not address anticholinergic effects specifically. Using cooling measures to decrease fever is not relevant to managing dry mouth caused by anticholinergic effects. Taking an antacid to relieve nausea is unrelated to managing dry mouth, which is the focus of anticholinergic effects.

2. A client is receiving discharge instructions for a new prescription of Warfarin. Which of the following over-the-counter medications should the client be instructed to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. Patients on Warfarin should avoid NSAIDs like Ibuprofen and opt for alternative pain relief options to prevent potential complications such as an increased risk of bleeding. Acetaminophen (Choice A), Diphenhydramine (Choice C), and Loratadine (Choice D) are not known to significantly interact with Warfarin in terms of bleeding risk and are generally considered safe to use alongside Warfarin.

3. Which of the following is classified as a class IA Sodium Channel blocker?

• A. Quinidine
• B. Disopyramide
• C. Aminodarone
• D. Propafenone

Correct answer: A

Rationale: Quinidine is classified as a class IA sodium channel blocker. Class IA antiarrhythmics, like quinidine, work by blocking sodium channels and delaying repolarization. Propafenone, mentioned in the original rationale, is actually a class IC antiarrhythmic agent, not a class IA sodium channel blocker.

4. During an admission assessment for a client with severe Aspirin toxicity, what finding should the nurse expect?

• A. Body temperature 35°C (95°F)
• B. Lung crackles
• C. Cool, dry skin
• D. Respiratory depression

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression can occur due to increasing respiratory acidosis. Aspirin toxicity leads to metabolic acidosis, stimulating the respiratory center in the brain to increase the respiratory rate initially. However, as the toxicity worsens, respiratory muscle fatigue and depression can occur, resulting in respiratory depression. This can lead to hypoxia, respiratory failure, and ultimately, respiratory arrest.

5. A client is receiving long-term aspirin therapy. The healthcare provider should monitor the client for which of the following complications?

• A. Hemorrhagic stroke
• B. Thromboembolic stroke
• C. Iron deficiency anemia
• D. Neutropenia

Correct answer: A

Rationale: The correct answer is A: Hemorrhagic stroke. Long-term aspirin therapy can lead to hemorrhagic stroke due to its antiplatelet effects, which increase the risk of bleeding. Aspirin inhibits platelet aggregation, which can predispose the individual to bleeding complications, including hemorrhagic stroke. Choices B, C, and D are incorrect because aspirin therapy is more likely to cause bleeding complications rather than thromboembolic events, iron deficiency anemia, or neutropenia.

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