Nursing Elites

1. A client is prescribed diazepam for muscle spasms. What instruction should the nurse include in the client's teaching plan?

• A. Avoid drinking alcohol
• B. Take with food to avoid gastrointestinal upset
• C. Increase fluid intake
• D. Take medication with grapefruit juice

Correct answer: A

Rationale: The correct instruction for a client prescribed diazepam for muscle spasms is to avoid drinking alcohol. Diazepam can cause drowsiness and enhance the effects of alcohol, leading to increased sedation and impaired cognitive function. Clients should be advised to avoid alcohol consumption while taking diazepam to prevent these adverse effects and ensure their safety.

2. A client is admitted to a long-term care facility, and the nurse and a new employee are conducting medication reconciliation. The nurse notes that oxybutynin has been prescribed. The nurse realizes the new employee understands the drug's effect if the new employee explains that this medication is prescribed to treat which condition?

• A. Pain
• B. Depression
• C. Overactive bladder
• D. Chronic anxiety

Correct answer: C

Rationale: The correct answer is C: Overactive bladder. Oxybutynin is prescribed to treat overactive bladder by reducing muscle spasms of the bladder. It is classified as an anticholinergic medication. Choices A, B, and D are incorrect. Oxycodone is an opioid used for pain management. Bupropion is an antidepressant used to treat depression. Buspirone is an anxiolytic used to manage anxiety disorders.

3. A client with a diagnosis of generalized anxiety disorder is prescribed fluvoxamine. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Insomnia
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Fluvoxamine is known to cause drowsiness as a potential side effect. Patients should be advised to avoid activities like driving that require alertness until they understand how the medication affects them. Dry mouth, insomnia, and headache are potential side effects of other medications used for anxiety disorders but are not typically associated with fluvoxamine.

4. In the emergency department, a child is admitted for accidental ingestion of a poison. The practical nurse (PN) should know that inducing vomiting is recommended for which child?

• A. An 8-month-old who ingested four to six ibuprofen tablets
• B. A 3-year-old who drank an unknown amount of charcoal lighter fluid
• C. A 16-month-old who ingested 2 ounces of acetaminophen elixir
• D. A 2-year-old who ate a handful of automatic dishwasher detergent

Correct answer: C

Rationale: Inducing emesis is recommended for the child who ingested a large dose of acetaminophen elixir because this medication is hepatotoxic. Acetaminophen overdose can lead to severe liver damage, and prompt removal from the stomach can help reduce absorption and potential harm.

5. A client with a history of deep vein thrombosis is prescribed enoxaparin. The nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: Enoxaparin is an anticoagulant that works by preventing blood clots. One of the potential adverse effects of enoxaparin is an increased risk of bleeding due to its anticoagulant properties. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, petechiae, or blood in stool or urine, to ensure timely intervention and prevent complications.

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