Nursing Elites

1. A client in a substance abuse clinic is being assessed by a nurse after discontinuing disulfiram due to severe nausea and vomiting. What is the likely cause of the client's distress?

• A. The client demonstrated an allergic response to the medication.
• B. The client experienced a common side effect of the medication.
• C. The client consumed alcohol while taking the medication.
• D. The client took an overdose of the medication.

Correct answer: C

Rationale: Disulfiram, when combined with alcohol, leads to a severe reaction causing nausea and vomiting. Since the client experienced these symptoms after starting disulfiram, it is likely that they consumed alcohol while taking the medication. Choice A is incorrect because the symptoms are more indicative of the interaction with alcohol rather than an allergic response. Choice B is incorrect as severe nausea and vomiting are not common side effects of disulfiram alone. Choice D is incorrect as there is no indication of an overdose based on the symptoms described.

2. A client has a new prescription for Atenolol. Which of the following statements should be included by the healthcare provider?

• A. Take the medication with a high-fat meal.
• B. Monitor your heart rate before taking the medication.
• C. Expect a persistent cough.
• D. Avoid foods high in fiber.

Correct answer: B

Rationale: When a client is prescribed Atenolol, a beta-blocker, they should monitor their heart rate before taking the medication. It is crucial because if the heart rate is below 60 bpm, the client needs to contact their healthcare provider for further guidance and evaluation. Choices A, C, and D are incorrect. Atenolol does not need to be taken with a high-fat meal, does not typically cause a persistent cough, and there is no need to avoid foods high in fiber when taking this medication.

3. A client is reviewing a new prescription for Terbutaline with a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

• A. I can increase my activity now that I've started on this medication.
• B. I will increase my daily fluid intake to 3 quarts.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider as these are signs of preterm labor. Monitoring contractions is crucial for the management of preterm labor and the safety of both the client and the fetus. Choices A, B, and D are incorrect because increasing activity, fluid intake, or assuming the medication will prevent preterm labor do not address the essential need to report changes in contractions, which are a vital sign of potential complications in preterm labor.

4. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients experiencing tachycardia, including those with reflex tachycardia induced by medications like Isosorbide Mononitrate. Furosemide (Choice A) is a diuretic and is not indicated for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor used for hypertension and heart failure, not tachycardia. Ranolazine (Choice C) is used in chronic angina but does not address tachycardia.

5. A client with Angina Pectoris asks the nurse about the next step if they take one tablet, wait 5 minutes, but still have Anginal pain. Which response should the nurse provide?

• A. Take two more sublingual tablets at the same time.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes then take a second sublingual tablet.

Correct answer: B

Rationale: If anginal pain persists after taking the first tablet and waiting 5 minutes, the priority step is to call emergency services (911) and then take a second sublingual tablet. Persistent pain could indicate a myocardial infarction, and immediate medical attention is crucial. Taking two more tablets at the same time (Choice A) can lead to excessive vasodilation and hypotension. Taking a sustained-release nitroglycerin capsule (Choice C) is not appropriate for immediate relief during an acute episode. Waiting another 5 minutes and then taking a second tablet (Choice D) is not advisable in this emergency situation where prompt action is necessary.

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