Nursing Elites

1. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

2. A client with a diagnosis of schizophrenia is prescribed lurasidone. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Weight gain. When a client is prescribed lurasidone, monitoring for weight gain is essential as lurasidone can cause this side effect. Patients on lurasidone should have their weight monitored regularly to detect any changes that may occur. Options B, C, and D are not typically associated with lurasidone use, making them less likely to be a direct side effect of this medication.

3. A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?

• A. Determine if the medication is being taken correctly
• B. Provide instructions on managing these side effects
• C. Schedule an appointment for evaluation by the healthcare provider
• D. Advise stopping the medication until the unpleasant side effects wear off

Correct answer: B

Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.

4. 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.

5. The patient is prescribed cimetidine (Tagamet) orally. What should the nurse consider about administering this drug?

• A. Administer the drug with the first bite of food
• B. Administer the drug immediately after meals
• C. Administer the drug 30 minutes after meals
• D. Administer the drug 30 minutes before meals

Correct answer: D

Rationale: Cimetidine is best absorbed when taken 30 minutes before meals to decrease stomach acid. Administering it before meals allows for optimal absorption and effectiveness of the medication. Choices A, B, and C are incorrect because administering cimetidine with food, immediately after meals, or 30 minutes after meals may not provide the best conditions for absorption. Taking it before meals ensures that the drug is absorbed properly and can exert its intended effects.

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