Nursing Elites

1. A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient?

• A. Phenytoin (Dilantin)
• B. Lithium
• C. Alprazolam (Xanax)
• D. Spironolactone

Correct answer: C

Rationale: Alprazolam (Xanax) is a medication commonly prescribed to treat anxiety disorders and panic attacks. It belongs to the class of medications known as benzodiazepines, which work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain to produce a calming effect. Phenytoin is an antiepileptic drug, not typically used for anxiety or panic attacks. Lithium is primarily used to treat bipolar disorder, not anxiety. Spironolactone is a diuretic primarily used to treat conditions like high blood pressure and heart failure, not anxiety or panic attacks.

2. A client is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should be administered to suppress normal flora in the GI tract?

• A. Kanamycin
• B. Gentamicin
• C. Neomycin
• D. Tobramycin

Correct answer: C

Rationale: The correct answer is C: Neomycin. Neomycin, an aminoglycoside antibiotic, is administered orally before GI surgery to eliminate the normal flora in the large intestine. This helps reduce the risk of postoperative infections by decreasing the bacterial load in the gut. Choices A, B, and D (Kanamycin, Gentamicin, Tobramycin) are not typically used to suppress normal flora in the GI tract before colorectal surgery.

3. When teaching the parents of a child who has a new prescription for Desipramine, which of the following adverse effects should the nurse instruct the parents is the priority to report to the provider?

• A. Constipation
• B. Suicidal thoughts
• C. Photophobia
• D. Dry mouth

Correct answer: B

Rationale: The priority adverse effect to report when a child is taking Desipramine is suicidal thoughts. Desipramine can lead to an increased risk of suicidal thoughts and behaviors. The nurse should emphasize to the parents the importance of monitoring the child for any signs of worsening depression or suicidal ideation. Prompt reporting of such symptoms can help prevent harm to the child. Choices A, C, and D are not the priority adverse effects associated with Desipramine. While constipation, photophobia, and dry mouth can occur as side effects of Desipramine, they are not as critical as the risk of suicidal thoughts, which requires immediate attention to ensure the safety of the child.

4. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?

• A. Stop the infusion.
• B. Call the provider.
• C. Elevate the head of the bed.
• D. Auscultate breath sounds.

Correct answer: A

Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.

5. A client with brain cancer and headaches is prescribed dexamethasone. What is the purpose of this adjuvant medication?

• A. To decrease inflammation and swelling
• B. To improve concentration
• C. To induce sedation
• D. To treat depression

Correct answer: A

Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer to decrease inflammation and swelling. It helps reduce cerebral edema and relieve pressure caused by the tumor, ultimately alleviating headaches. The purpose of prescribing dexamethasone in this case is not to improve concentration (choice B), induce sedation (choice C), or treat depression (choice D). Methylphenidate, a stimulant, is used for conditions like ADHD, not for brain cancer. Hydroxyzine, an antihistamine, is primarily used for anxiety and itching, not for brain cancer. Amitriptyline, a tricyclic antidepressant, is used for conditions like depression and neuropathic pain, not specifically for brain cancer-related headaches.

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