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 healthcare professional is educating a client who is beginning therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Prompt reporting of dyspnea allows for timely evaluation and management to prevent potential complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings that the client should report.

3. A client has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide?

• A. Take the medication on an empty stomach to decrease gastrointestinal irritation.
• B. Take the medication with orange juice to enhance absorption.
• C. Take the medication with milk.
• D. Rinse the mouth before taking the iron.

Correct answer: B

Rationale: Taking ferrous sulfate with orange juice can help increase the absorption of iron. Orange juice contains vitamin C, which aids in the absorption of iron from the medication. This combination can enhance the effectiveness of the iron supplement for a client with anemia. Option A is incorrect because taking iron on an empty stomach can cause gastrointestinal upset. Option C is incorrect because calcium in milk can inhibit iron absorption. Option D is irrelevant to enhancing iron absorption.

4. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

5. A client is receiving moderate sedation with Diazepam IV and is oversedated. Which of the following medications should the nurse anticipate administering to this client?

• A. Ketamine
• B. Naltrexone
• C. Flumazenil
• D. Fluvoxamine

Correct answer: C

Rationale: Flumazenil is a competitive benzodiazepine antagonist that can reverse the sedative effects of benzodiazepines like Diazepam. In cases of oversedation, administering Flumazenil can help counteract the excessive sedation and other effects of Diazepam, thereby promoting the client's recovery and preventing potential complications. Ketamine (Choice A) is a dissociative anesthetic and not used to reverse benzodiazepine sedation. Naltrexone (Choice B) is an opioid receptor antagonist, not indicated for benzodiazepine oversedation. Fluvoxamine (Choice D) is an antidepressant and not used to reverse the sedative effects of benzodiazepines.

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