Nursing Elites

1. A client with end-stage cancer receiving Morphine has been prescribed Methylnaltrexone. The client's daughter asks about the purpose of Methylnaltrexone. Which response should the nurse provide?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: Methylnaltrexone is an opioid antagonist used to treat severe constipation unresponsive to laxatives in opioid-dependent clients. It functions by blocking the mu opioid receptors in the gastrointestinal tract, helping alleviate constipation associated with opioid use. Choices A, B, and D are incorrect. Methylnaltrexone does not increase respirations, prevent dependence on Morphine, or work with Morphine to increase pain relief; its primary purpose is to relieve opioid-induced constipation.

2. What symptoms should a patient taking Omeprazole report to the healthcare provider?

• A. Black, tarry stools
• B. Diarrhea
• C. Abdominal pain
• D. All of the above

Correct answer: D

Rationale: Patients taking Omeprazole should report black, tarry stools, diarrhea, or abdominal pain to the healthcare provider because these symptoms could indicate serious side effects associated with the medication. Black, tarry stools may suggest gastrointestinal bleeding, diarrhea can be a sign of a gastrointestinal infection or adverse drug reaction, and abdominal pain may indicate underlying issues that need attention. Choosing 'All of the above' is the correct answer as all these symptoms are important to report for proper evaluation and management.

3. When teaching a client who has a new prescription for Ciprofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with an antacid.
• B. Avoid direct sunlight.
• C. Increase your intake of dairy products.
• D. Expect urine to turn orange.

Correct answer: B

Rationale: The correct instruction for a client prescribed Ciprofloxacin is to avoid direct sunlight. Ciprofloxacin can cause photosensitivity, increasing the risk of sunburn. Clients should be advised to avoid direct sunlight and wear protective clothing, including hats and sunglasses when going outdoors to prevent skin damage. Choices A, C, and D are incorrect. Taking Ciprofloxacin with an antacid can reduce its absorption, so they should not be taken together. Increasing dairy product intake is not necessary or relevant to taking Ciprofloxacin. While Ciprofloxacin can discolor urine, turning it orange, this is not a critical side effect that requires specific instructions for the client.

4. When teaching the family of a child with Cystic Fibrosis about a new prescription for Acetylcysteine, which information should the nurse include?

• A. Expect this medication to suppress your cough.
• B. Expect this medication to smell like rotten eggs.
• C. Expect this medication to cause euphoria.
• D. Expect this medication to turn your urine orange.

Correct answer: B

Rationale: The correct answer is B: 'Expect this medication to smell like rotten eggs.' Acetylcysteine contains sulfur, which gives it a characteristic rotten-egg odor. This odor is normal and expected when using this medication. Choices A, C, and D are incorrect because Acetylcysteine is not used to suppress cough, cause euphoria, or change urine color. Educating the family on the distinct smell of Acetylcysteine will help them understand its characteristics and alleviate concerns about the odor.

5. A client has a new prescription for Furosemide to treat heart failure. Which of the following laboratory results should the nurse monitor?

• A. Potassium level
• B. Sodium level
• C. Hemoglobin A1C
• D. BUN

Correct answer: A

Rationale: The nurse should monitor the client's potassium levels when taking Furosemide because the medication can lead to hypokalemia. Hypokalemia is a potential side effect of Furosemide, a loop diuretic, due to increased potassium excretion in the urine. Monitoring potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with low potassium levels. Therefore, choices B (Sodium level), C (Hemoglobin A1C), and D (BUN) are incorrect as they are not directly influenced by Furosemide therapy for heart failure.

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