Nursing Elites

1. A client with a UTI and a history of recurrent infections asks why the provider has not yet prescribed an antibiotic. The nurse should explain that the provider has to wait for the results of which of the following laboratory tests to identify which antibiotic to prescribe?

• A. Gram stain
• B. Culture
• C. Sensitivity
• D. Specific gravity

Correct answer: C

Rationale: In the case of a UTI, a sensitivity test is crucial as it identifies the most effective antibiotic to target the specific microorganism causing the infection. This test helps in prescribing the appropriate antibiotic for successful treatment and preventing antibiotic resistance. While a Gram stain and culture are important in diagnosing a UTI, the sensitivity test specifically determines the most suitable antibiotic. Specific gravity, on the other hand, is not related to identifying the appropriate antibiotic for a UTI.

2. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: The client's symptoms of face spasms after receiving Prochlorperazine indicate acute dystonia, a known side effect. Diphenhydramine is commonly administered to manage extrapyramidal symptoms, such as muscle spasms, caused by medications like Prochlorperazine. Therefore, the nurse should anticipate a prescription for Diphenhydramine to alleviate the client's symptoms. Choices A, B, and C are incorrect because Fomepizole is used in methanol or ethylene glycol poisoning, Naloxone is an opioid antagonist used in opioid overdose, and Phytonadione is vitamin K, used to reverse the effects of certain blood thinners.

3. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

• A. This medication can stain your contacts.
• B. This medication can cause your pupils to constrict.
• C. This medication can absorb into your contacts.
• D. This medication can slow your heart rate.

Correct answer: C

Rationale: The correct answer is C. Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove their contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid potential absorption of the medication by the lenses. Choices A, B, and D are incorrect because Brimonidine's main concern with contact lenses is its absorption into the lenses rather than staining contacts, causing pupil constriction, or affecting heart rate.

4. When a client is taking Somatropin to stimulate growth, what should the healthcare provider monitor the client's urine for?

• A. Bilirubin
• B. Protein
• C. Potassium
• D. Calcium

Correct answer: D

Rationale: When a client is taking Somatropin to stimulate growth, monitoring urine for calcium is essential. Somatropin can lead to increased calcium levels in the urine, potentially increasing the risk of renal calculi formation. Therefore, assessing for calcium in the urine helps in early detection and prevention of this complication. Monitoring for bilirubin, protein, or potassium in the urine is not directly related to the effects of Somatropin and would not provide relevant information in this context.

5. A client is starting to take amitriptyline. The healthcare provider should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Urinary retention
• C. Bradycardia
• D. Dry cough

Correct answer: B

Rationale: The correct answer is B: Urinary retention. Amitriptyline, a tricyclic antidepressant, can cause relaxation of the bladder sphincter muscles, leading to urinary retention. Monitoring for urinary retention is crucial as it is a common anticholinergic effect associated with this medication. Diarrhea (choice A) is not a common adverse effect of amitriptyline. Bradycardia (choice C) is more commonly associated with beta-blockers rather than tricyclic antidepressants like amitriptyline. Dry cough (choice D) is not a typical adverse effect of amitriptyline.

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