Nursing Elites

1. A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?

• A. My urine may turn brown or green.
• B. This medication is prescribed to help relieve my muscle spasms.
• C. If my vision becomes blurred, I need to be concerned about it.
• D. I need to call my doctor if I experience nasal congestion from this medication.

Correct answer: C

Rationale: The correct answer is C because blurred vision is an adverse effect of methocarbamol (Robaxin) and should be reported to a healthcare provider. Choices A, B, and D are all correct statements. Option A informs the client about a possible discoloration of urine, which is a known side effect. Option B correctly explains the purpose of the medication. Option D correctly advises the client to contact their doctor if they experience nasal congestion, which could indicate an adverse reaction.

2. An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?

• A. Tremors
• B. Dizziness
• C. Confusion
• D. Hallucinations

Correct answer: C

Rationale: Older clients are particularly vulnerable to central nervous system side effects of cimetidine. The most frequent side effect is confusion. It is crucial for nurses to be vigilant in monitoring for confusion as it can impact the client's safety and well-being. While tremors, dizziness, and hallucinations are possible side effects, confusion is the most common in older clients taking cimetidine.

3. A client is receiving bethanechol chloride (Urecholine). The nurse monitors the client for adverse effects of the medication and should observe for which of the following?

• A. Bradycardia
• B. Constipation
• C. Hypertension
• D. Dry mouth

Correct answer: A

Rationale: Corrected Rationale: Bethanechol chloride (Urecholine) stimulates muscarinic receptors, which can lead to bradycardia as an adverse effect. Monitoring for bradycardia is crucial when administering this medication. Constipation, hypertension, and dry mouth are not typically associated with the effects of bethanechol chloride. Bradycardia is the correct adverse effect to monitor for, making option A the correct answer. Constipation, hypertension, and dry mouth are not commonly seen with bethanechol chloride and are therefore incorrect choices.

4. A client is receiving dietary instructions from a nurse regarding warfarin sodium (Coumadin) therapy. The nurse advises the client to avoid which food item?

• A. Grapes
• B. Spinach
• C. Watermelon
• D. Cottage cheese

Correct answer: B

Rationale: The correct answer is B: Spinach. Spinach is high in vitamin K, which antagonizes the effects of warfarin sodium, an anticoagulant medication. Clients taking warfarin should avoid consuming foods rich in vitamin K, like spinach, to maintain the medication's effectiveness. Grapes (choice A), watermelon (choice C), and cottage cheese (choice D) do not interfere with the effects of warfarin, so they are safe for the client to consume while on warfarin therapy.

5. A nurse is monitoring a client receiving lithium carbonate for bipolar disorder. Which finding should the nurse report immediately to the healthcare provider?

• A. Increased thirst
• B. Fine hand tremors
• C. Frequent urination
• D. Persistent vomiting

Correct answer: D

Rationale: Persistent vomiting can be a sign of lithium toxicity, which requires immediate medical attention. Increased thirst, fine hand tremors, and frequent urination are common side effects of lithium.

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