Nursing Elites

1. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?

• A. Stimulant laxatives
• B. Bulk-forming laxatives
• C. Emollient laxatives
• D. Hyperosmotic laxatives

Correct answer: B

Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.

2. The healthcare provider is assessing the effectiveness of the drug amiodarone. Which client statement best indicates that the drug has been effective?

• A. I have not had as many spells of angina.
• B. I have not had as much swelling in my ankles lately.
• C. My doctor told me my cholesterol levels were improving with each visit.
• D. I do not notice as many irregular heartbeats as before I started taking this medication.

Correct answer: D

Rationale: The correct answer is option D. The effectiveness of amiodarone is best assessed by a reduction in irregular heartbeats since it is primarily used to treat ventricular dysrhythmias. This drug's main purpose is to control irregular heart rhythms, so a decrease in irregular heartbeats indicates its effectiveness. Options A, B, and C are incorrect because amiodarone is not primarily used to address angina, ankle swelling, or cholesterol levels, so improvements in these areas do not directly reflect the drug's effectiveness.

3. Twenty-four hours after starting to take oral penicillin for strep throat, a client calls the nurse to report the onset of a rash on the chest. What action should the nurse implement?

• A. Instruct the client to discontinue the penicillin immediately
• B. Instruct the client regarding the use of topical analgesic cream PRN
• C. Question the client about any other related symptoms
• D. Reinforce the need to take all doses of the penicillin

Correct answer: A

Rationale: In this scenario, the client has developed a rash after starting oral penicillin, which can indicate an allergic reaction. It is crucial for the nurse to instruct the client to discontinue the penicillin immediately. Continuing the medication can potentially lead to severe allergic reactions. Instructing about topical analgesic cream or questioning about other related symptoms may delay appropriate action in case of a severe allergic reaction. Reinforcing the need to complete all doses is not appropriate when an allergic reaction is suspected, as safety takes precedence over completing the antibiotic course.

4. A client with a diagnosis of bipolar disorder is prescribed quetiapine. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Hair loss
• C. Insomnia
• D. Tremors

Correct answer: A

Rationale: When a client with bipolar disorder is prescribed quetiapine, the nurse should monitor for weight gain as a potential adverse effect. Quetiapine is known to commonly cause weight gain, which can have implications for the client's overall health. Regular monitoring of weight can help in early detection and management of this side effect.

5. A 67-year-old client is discharged from the hospital with a prescription for digoxin 0.25 mg daily. Which instruction by the practical nurse (PN) is correct?

• A. Take the medication in the morning before getting out of bed.
• B. Do not take the medication if the heartbeat is irregular or slow.
• C. Expect some vision changes due to the medication.
• D. Increase intake of foods rich in potassium.

Correct answer: B

Rationale: The correct instruction for a client taking digoxin is not to take the medication if the heartbeat is irregular or slow. Digoxin can affect the heart rhythm, so it is crucial to monitor the pulse rate. In case of irregular or slow heartbeats, the medication should be withheld, and the healthcare provider should be consulted. This step is necessary to prevent potential complications associated with digoxin therapy. Choices A, C, and D are incorrect. Taking digoxin in the morning before getting out of bed is not a specific requirement. Vision changes are not a common side effect of digoxin. While digoxin can affect potassium levels, it is not advised to increase potassium intake without healthcare provider guidance.

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