Nursing Elites

1. 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.

2. The healthcare provider is discharging a patient with a new prescription for ranitidine (Zantac). Which information would be important to include in the discharge teaching?

• A. Thrombolytic thrombocytopenic purpura (TTP) may occur
• B. Aspirin should not be taken with this medication
• C. The patient may experience iron deficiency anemia
• D. The patient may experience restlessness

Correct answer: D

Rationale: The correct answer is D. It is important to include information that ranitidine may cause restlessness as a side effect in some patients. Educating the patient about possible side effects helps in early recognition and management, improving medication adherence and patient safety. Choices A, B, and C are incorrect because they do not pertain to common side effects or specific considerations related to ranitidine use.

3. What instruction should the nurse include in the teaching plan for a client prescribed ranitidine for a peptic ulcer?

• A. Take this medication in the morning before breakfast.
• B. Take this medication with meals.
• C. Avoid taking this medication with antacids.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed ranitidine for a peptic ulcer is to take the medication in the morning before breakfast. This timing helps reduce stomach acid production throughout the day, providing optimal therapeutic effects. Option B is incorrect because taking ranitidine with meals is not the recommended timing. Option C is incorrect as there is no specific contraindication against taking ranitidine with antacids. Option D is incorrect as the medication should not be taken at bedtime but rather in the morning before breakfast.

4. A client admitted with shortness of breath and palpitations currently takes an antiarrhythmic medication, dronedarone. Which action should the nurse take to prevent arrhythmias?

• A. Measure orthostatic blood pressure
• B. Obtain a 12-lead ECG reading daily
• C. Assess the client's apical pulse daily
• D. Provide continuous ECG monitoring

Correct answer: D

Rationale: The correct action to prevent arrhythmias in a client taking an antiarrhythmic medication like dronedarone is to provide continuous ECG monitoring. This is essential because antiarrhythmic drugs can sometimes cause pro-arrhythmic effects, which may lead to dangerous heart rhythm disturbances. Continuous ECG monitoring allows for real-time detection of any abnormal rhythms, enabling prompt intervention. Measuring orthostatic blood pressure, obtaining a 12-lead ECG reading daily, and assessing the client's apical pulse daily are important assessments in general patient care but may not specifically prevent arrhythmias in this scenario.

5. A client with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. The nurse should assess the client for which potential side effect?

• A. Nausea
• B. Dry mouth
• C. Cough
• D. Palpitations

Correct answer: B

Rationale: The correct answer is B: Dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. Anticholinergic medications like ipratropium can lead to decreased salivary flow, resulting in dry mouth. Choices A, C, and D are incorrect because nausea, cough, and palpitations are not commonly associated with ipratropium use.

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