Nursing Elites

1. 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.

2. A client with Subacute Bacterial Endocarditis is receiving Streptomycin IM among other antibiotics. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

• A. Extremity paresthesias
• B. Urinary retention
• C. Severe constipation
• D. Complex partial seizures

Correct answer: A

Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly. Choices B, C, and D are incorrect because urinary retention, severe constipation, and complex partial seizures are not commonly associated adverse effects of Streptomycin.

3. What is a desired outcome of the drug Phenytoin?

• A. Decrease symptoms of PTSD
• B. Resolution of signs of infection
• C. Decrease or cessation of seizures without excessive sedation
• D. Prevention or relief of bronchospasm

Correct answer: C

Rationale: The correct answer is C: Decrease or cessation of seizures without excessive sedation. Phenytoin is primarily used as an antiepileptic medication to manage and prevent seizures. It does not directly impact symptoms of PTSD (Choice A), resolution of signs of infection (Choice B), or prevention or relief of bronchospasm (Choice D). Therefore, the desired outcome of Phenytoin is to control seizures effectively while avoiding excessive sedation.

4. A client with Diabetes is experiencing Nausea due to Gastroparesis. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Lubiprostone
• B. Metoclopramide
• C. Bisacodyl
• D. Loperamide

Correct answer: B

Rationale: Metoclopramide, a dopamine antagonist, is indicated for treating nausea and increasing gastric motility. In the context of diabetic gastroparesis, it can alleviate bloating and nausea by enhancing gastric emptying. Lubiprostone (Choice A) is a chloride channel activator used for chronic idiopathic constipation and irritable bowel syndrome with constipation. Bisacodyl (Choice C) is a stimulant laxative primarily used for constipation. Loperamide (Choice D) is an anti-diarrheal agent and would not be appropriate for treating nausea and gastroparesis.

5. A client has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Sodium level of 140 mEq/L
• D. Creatinine level of 1.0 mg/dL

Correct answer: A

Rationale: An INR of 4.0 is above the therapeutic range for a client on Warfarin, indicating an increased risk of bleeding. This finding requires immediate reporting to the provider for appropriate intervention to prevent complications associated with excessive anticoagulation. Potassium, sodium, and creatinine levels are within normal ranges and are not directly related to the risk of bleeding in a client on Warfarin therapy.

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