Nursing Elites

1. A client is prescribed Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?

• A. Dry mouth
• B. Hypertension
• C. Excessive perspiration
• D. Fecal impaction

Correct answer: C

Rationale: Bethanechol is a muscarinic agonist, which stimulates muscarinic receptors. Activation of these receptors can lead to increased sweating (excessive perspiration) as a manifestation of muscarinic stimulation. Options A, B, and D are not typically associated with muscarinic stimulation. Dry mouth is a common side effect of anticholinergic medications, hypertension is not a common manifestation of muscarinic stimulation, and fecal impaction is not directly related to muscarinic receptor activation.

2. A client is starting a new prescription for verapamil. Which of the following instructions should be included?

• A. Take the medication with a full glass of water.
• B. Avoid grapefruit juice.
• C. Monitor blood pressure regularly.
• D. Monitor heart rate daily.

Correct answer: B

Rationale: Clients prescribed verapamil should be advised to avoid grapefruit juice as it can potentiate the drug's effects, leading to adverse reactions. Grapefruit juice can inhibit the metabolism of verapamil, resulting in higher blood levels of the medication and an increased risk of side effects. Instructions such as taking the medication with a full glass of water (Choice A) are not specific to verapamil and are generally recommended. While monitoring blood pressure regularly (Choice C) is important for clients on antihypertensive medications, it is not a direct concern related to verapamil. Monitoring heart rate daily (Choice D) is not a primary consideration when starting verapamil, as it is more commonly used for its effects on blood pressure and arrhythmias rather than heart rate.

3. A client has a new prescription for Warfarin. Which of the following statements should the nurse include in the teaching?

• A. You will need to have your blood tested regularly while taking this medication.
• B. It is safe to take over-the-counter NSAIDs with this medication.
• C. You will need to avoid foods high in vitamin K while taking this medication.
• D. You will need to take this medication with food.

Correct answer: C

Rationale: Warfarin interacts with vitamin K, so clients should be instructed to avoid foods high in vitamin K. This is because vitamin K can interfere with the anticoagulant effects of Warfarin. It is important to maintain a consistent intake of vitamin K-containing foods to keep the medication working effectively. Therefore, the correct statement for the nurse to include in the teaching is to advise the client to avoid foods high in vitamin K while taking Warfarin. Choices A, B, and D are incorrect. Regular blood testing is necessary with Warfarin to monitor its effects and adjust the dosage if needed (Choice A). Taking over-the-counter NSAIDs with Warfarin is not safe due to an increased risk of bleeding (Choice B). Warfarin can be taken with or without food, so there is no specific requirement to take it with food (Choice D).

4. A healthcare professional is preparing to administer Butorphanol to a client who has a history of substance use disorder. The healthcare professional should identify which of the following information as true regarding Butorphanol?

• A. Butorphanol has a lower risk of abuse than morphine.
• B. Butorphanol causes a lower incidence of respiratory depression than morphine.
• C. Butorphanol can be reversed with an opioid antagonist.
• D. Butorphanol can cause abstinence syndrome in opioid-dependent clients.

Correct answer: D

Rationale: The correct answer is D. Butorphanol is an opioid agonist/antagonist that can precipitate withdrawal symptoms in opioid-dependent individuals. Symptoms of abstinence syndrome can include abdominal pain, fever, and anxiety. This occurs because butorphanol competes with and displaces opioid agonists from receptors, leading to withdrawal symptoms in opioid-dependent clients. Choices A, B, and C are incorrect. Butorphanol does not have a lower risk of abuse than morphine, it can cause respiratory depression similar to other opioids, and although it is an opioid antagonist, it does not get reversed by opioid antagonists.

5. A client has a prescription for Furosemide. Which of the following instructions should the nurse include?

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect your urine to turn orange.
• D. Avoid prolonged sunlight exposure.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Furosemide is a loop diuretic that can lead to hypokalemia (low potassium levels) due to increased excretion of potassium in the urine. To counteract this effect and maintain electrolyte balance, the client should be advised to increase their intake of potassium-rich foods. This instruction helps prevent potential complications associated with low potassium levels. Choices A, C, and D are incorrect. Taking Furosemide in the morning does not affect its effectiveness; urine turning orange is not an expected side effect of Furosemide; and avoiding prolonged sunlight exposure is not directly related to Furosemide use.

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