Nursing Elites

1. A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:

• A. Avoid drinking alcohol.
• B. Report yellow eyes or skin immediately.
• C. Avoid Swiss or aged cheeses.
• D. Avoid vitamin supplements during therapy.

Correct answer: B

Rationale: When a client is on isoniazid (INH) therapy, they should be instructed to report any signs of hepatitis, such as yellowing of the eyes or skin, immediately. Alcohol consumption should be avoided during INH therapy due to the risk of hepatotoxicity. Foods high in tyramine, such as Swiss or aged cheeses, should also be avoided to prevent adverse reactions. Additionally, while on INH therapy, it is essential to avoid vitamin supplements containing pyridoxine (vitamin B6) to prevent potential interactions.

2. A client is taking cetirizine hydrochloride (Zyrtec). The nurse checks for which of the following side effects of this medication?

• A. Diarrhea
• B. Excitability
• C. Drowsiness
• D. Excess salivation

Correct answer: C

Rationale: Cetirizine hydrochloride (Zyrtec) is known to commonly cause drowsiness or sedation as a side effect. Therefore, the nurse should monitor the client for signs of drowsiness when administering this medication. Choice A, Diarrhea, is not a common side effect of cetirizine. Choice B, Excitability, is not a typical side effect of this antihistamine; instead, it tends to cause drowsiness. Choice D, Excess salivation, is not associated with cetirizine use.

3. During an admission assessment, a client informs the nurse that they take propylthiouracil (PTU) daily. Based on this information, the nurse suspects that the client has a history of:

• A. Myxedema
• B. Graves' disease
• C. Addison's disease
• D. Cushing's syndrome

Correct answer: B

Rationale: Propylthiouracil (PTU) is a medication commonly used to treat hyperthyroidism, including Graves' disease, which is characterized by an overactive thyroid gland. The client mentioning the daily use of PTU indicates that they likely have a history of Graves' disease, as this medication helps manage the condition by reducing the production of thyroid hormones. Therefore, the correct answer is B: Graves' disease. Choice A, Myxedema, is incorrect as it refers to a condition of severe hypothyroidism, the opposite of hyperthyroidism. Choices C and D, Addison's disease and Cushing's syndrome, respectively, are unrelated to the use of PTU or hyperthyroidism, making them incorrect choices.

4. Before administering Methylergonovine (Methergine) to a client with postpartum hemorrhage caused by uterine atony, the nurse checks which of the following as the important client parameter?

• A. Temperature
• B. Lochial flow
• C. Urine output
• D. Blood pressure

Correct answer: D

Rationale: Methylergonovine (Methergine) acts by stimulating uterine contractions and causing vasoconstriction. As vasoconstriction can potentially impact blood pressure, it is crucial to check the client's blood pressure before administering Methylergonovine to monitor for any hypertensive effects.

5. The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:

• A. Immediately before swimming
• B. 15 minutes before exposure to the sun
• C. Immediately before exposure to the sun
• D. At least 30 minutes before exposure to the sun

Correct answer: D

Rationale: Chemical sunscreens are most effective when applied at least 30 minutes before exposure to the sun to allow them to penetrate the skin and provide optimal protection. Applying sunscreen immediately before swimming (Choice A) or immediately before exposure to the sun (Choice C) may not provide sufficient time for the sunscreen to be absorbed and offer proper protection. Applying sunscreen 15 minutes before sun exposure (Choice B) is also not ideal as it may not allow enough time for the sunscreen to work effectively. Therefore, the correct answer is to apply chemical sunscreen at least 30 minutes before exposure to the sun to ensure it can be absorbed and offer the intended protection. It is important to reapply sunscreen after swimming or sweating to maintain its effectiveness.

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