Nursing Elites

1. When monitoring a client for acute toxicity associated with bethanechol chloride (Urecholine), what sign should the nurse check for to indicate toxicity?

• A. Dry skin
• B. Dry mouth
• C. Bradycardia
• D. Signs of dehydration

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Toxicity from bethanechol chloride (Urecholine) can lead to excessive muscarinic stimulation, resulting in manifestations like salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. When facing toxicity, treatment involves supportive measures and administering atropine sulfate subcutaneously or intravenously.

2. A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?

• A. Constipation and bloating might be a problem.
• B. I'll continue to watch my diet and reduce my fats.
• C. Walking a mile each day will help the whole process.
• D. I'll continue my nicotinic acid from the health food store.

Correct answer: D

Rationale: Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.

3. A client is receiving instructions from a healthcare provider about intranasal desmopressin acetate (DDAVP). The healthcare provider explains that which of the following is a side effect of the medication?

• A. Headache
• B. Vulval pain
• C. Runny nose
• D. Flushed skin

Correct answer: C

Rationale: Intranasal desmopressin can cause a runny or stuffy nose as a side effect due to its mode of administration through the nasal passages.

4. After the initial dose, which of the following is the priority assessment for a client being treated for acute congestive heart failure with intravenously administered bumetanide?

• A. Monitoring weight loss
• B. Monitoring temperature
• C. Monitoring blood pressure
• D. Monitoring potassium level

Correct answer: C

Rationale: The correct answer is monitoring blood pressure. Bumetanide is a loop diuretic, and monitoring blood pressure is crucial as hypotension is a common side effect. Hypotension can further worsen the condition of a patient with congestive heart failure, so assessing and managing blood pressure is a priority after administering bumetanide.

5. A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the healthcare provider's office that a dose was taken this morning. The nurse determines that:

• A. The client should reschedule the appointment.
• B. A lower dose of allergen will need to be injected.
• C. A higher dose of allergen will need to be injected.
• D. The client should have the skin test read a day later than usual.

Correct answer: A

Rationale: Fexofenadine, an antihistamine, can cause false-negative readings in allergy skin testing and should be discontinued 3 days prior. Therefore, the client should reschedule the appointment to ensure accurate test results.

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