Nursing Elites

1. A client has a new prescription for Metoclopramide to treat nausea. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication before bedtime.
• B. I will discontinue this medication if I experience drowsiness.
• C. I should report restlessness or involuntary movements.
• D. This medication can change the color of my urine to orange.

Correct answer: C

Rationale: The correct answer is C. Reporting restlessness or involuntary movements is crucial as they can be signs of extrapyramidal symptoms, a potential side effect of Metoclopramide. These symptoms should be reported promptly to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because taking the medication before bedtime, discontinuing it due to drowsiness, or expecting urine color changes are not relevant teaching points for Metoclopramide use.

2. A client has a prescription for 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: The correct answer is C: Excessive perspiration. Bethanechol is a muscarinic agonist that stimulates muscarinic receptors. Activation of muscarinic receptors can lead to excessive perspiration (diaphoresis) due to increased cholinergic activity, affecting sweat glands. Dry mouth, hypertension, and fecal impaction are not typically associated with muscarinic stimulation. Dry mouth is more commonly associated with anticholinergic medications, hypertension can be a result of alpha-adrenergic stimulation, and fecal impaction is not a direct effect of muscarinic receptor activation.

3. A client has a new prescription for Filgrastim to treat neutropenia. Which of the following statements should the nurse include?

• A. This medication will help increase your white blood cell count.
• B. This medication will help reduce your risk of infection.
• C. This medication will help improve your red blood cell count.
• D. This medication will help increase your platelet count.

Correct answer: A

Rationale: The correct statement the nurse should include is that 'This medication will help increase your white blood cell count.' Filgrastim is a medication used to stimulate the production of white blood cells, specifically neutrophils, to increase the white blood cell count. This increase in white blood cells helps reduce the risk of infections in clients with neutropenia. Choices B, C, and D are incorrect because Filgrastim specifically targets white blood cells, not red blood cells or platelets.

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

• A. Take the medication at bedtime.
• B. Monitor your blood pressure regularly.
• C. Expect to have increased energy levels.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is to monitor blood pressure regularly. Hydralazine is an antihypertensive medication that helps lower blood pressure. Monitoring blood pressure regularly is essential to ensure it remains within the target range and to assess the effectiveness of the medication. Choice A is incorrect because the timing of taking Hydralazine is usually not specified as bedtime. Choice C is incorrect because increased energy levels are not an expected effect of Hydralazine. Choice D is incorrect because Hydralazine does not interact with potassium in the same way as other medications like potassium-sparing diuretics.

5. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. It is characterized by a decreased level of neutrophils, which are important in fighting infections. Monitoring the client's complete blood count (CBC) is crucial to detect neutropenia early. The nurse should also educate the client on recognizing signs of infection and promptly reporting them to the healthcare provider for timely intervention. Hypokalemia is a potential adverse effect of diuretics, not ACE inhibitors. Hypernatremia is an electrolyte imbalance more commonly associated with conditions like dehydration. Bradycardia is not a typical adverse effect of Captopril.

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