Nursing Elites

1. A client is prescribed cyclobenzaprine for muscle spasms. The nurse should instruct the client to avoid which substance while taking this medication?

• A. Alcohol
• B. Caffeine
• C. Nicotine
• D. Dairy products

Correct answer: A

Rationale: The correct answer is A: Alcohol. When taking cyclobenzaprine, it is important to avoid alcohol as it can potentiate the central nervous system depressant effects of the medication. This interaction can lead to increased drowsiness, dizziness, and impaired coordination. Therefore, it is essential for the client to refrain from alcohol consumption while on cyclobenzaprine to prevent these adverse effects and ensure their safety. Choices B, C, and D are incorrect because caffeine, nicotine, and dairy products do not have significant interactions with cyclobenzaprine. While caffeine and nicotine may have stimulant effects that could theoretically counteract some of the sedative effects of cyclobenzaprine, they are not contraindicated. Dairy products, on the other hand, do not interact with cyclobenzaprine and can be consumed safely.

2. A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?

• A. Increased risk of infection
• B. Bone marrow suppression
• C. Hair loss
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.

3. The practical nurse (PN) is obtaining the medical history of a client starting a new prescription for conjugated estrogens PO daily. Which medical condition is not treated by this medication?

• A. Menopausal symptoms
• B. Prostatic cancer
• C. Thromboembolic diseases
• D. Abnormal uterine bleeding

Correct answer: C

Rationale: Conjugated estrogens, such as Premarin, are not used in the treatment of thromboembolic diseases. These medications are contraindicated in conditions predisposing to thromboembolic diseases due to their association with an increased risk of thromboembolism, stroke, pulmonary embolism, and myocardial infarction. Choices A, B, and D are incorrect because conjugated estrogens are commonly prescribed for managing menopausal symptoms, abnormal uterine bleeding, and certain hormone-responsive cancers, but not for thromboembolic diseases.

4. A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

• A. Advise the client that the effects of the medication have worn off
• B. Explain that the medication is not given to relieve pain
• C. Check for the correct placement of the patch on the client
• D. Offer to apply a new transdermal patch to address the pain

Correct answer: B

Rationale: The correct answer is B. Scopolamine is not a pain medication; it is commonly used to prevent nausea and vomiting, particularly in surgical settings. It works on the central nervous system to help control these symptoms, not to relieve pain. Therefore, it is important for the nurse to explain to the client that the medication is not intended to relieve pain but rather to manage other specific symptoms. Checking the correct placement of the patch is also important to ensure proper administration, but addressing the misconception about the medication's purpose is the priority in this scenario. Offering to apply a new patch would not address the client's pain as scopolamine is not meant for pain relief. Advising the client that the effects have worn off is inaccurate because the medication is not used for pain management.

5. A healthcare professional prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's heart rate is 48 beats/min, respirations are 16 breaths/min, and blood pressure is 150/90 mmHg.

• A. Administer the dose and monitor the client's blood pressure regularly
• B. Apply a telemetry monitor before administering the dose
• C. Assess for orthostatic hypotension before administering the dose
• D. Withhold the scheduled dose and notify the healthcare provider

Correct answer: D

Rationale: The client's low heart rate of 48 beats/min indicates bradycardia, a potential side effect of labetalol. Administering the dose in this case could further lower the heart rate, potentially causing adverse effects. Therefore, it is crucial to withhold the scheduled dose and notify the healthcare provider for further assessment and guidance. Choice A is incorrect because administering the dose without addressing the bradycardia can exacerbate the condition. Choice B is not relevant in this situation as telemetry monitoring is not the priority. Choice C is also not the priority in this case, as the focus should be on the client's bradycardia and the potential adverse effects of administering labetalol.

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