Nursing Elites

1. Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy?

• A. Hepatotoxicity
• B. Wernicke's aphasia
• C. Suicidal ideations
• D. Diarrhea

Correct answer: A

Rationale: The correct answer is A: Hepatotoxicity. Disulfiram is known to cause hepatotoxicity as a severe adverse effect. This occurs due to the inhibition of aldehyde dehydrogenase, leading to the accumulation of acetaldehyde when alcohol is consumed. Wernicke's aphasia (Choice B) is a language disorder unrelated to disulfiram therapy. Suicidal ideations (Choice C) may be associated with certain medications, but it is not a common adverse effect of disulfiram. Diarrhea (Choice D) is not a typical adverse effect of disulfiram.

2. A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?

• A. a 45-degree angle
• B. a 60-degree angle
• C. a 75-degree angle
• D. a 90-degree angle

Correct answer: D

Rationale: Intramuscular injections in the ventrogluteal site should be administered at a 90-degree angle. This angle ensures that the medication reaches the muscle tissue effectively. Angles less than 90 degrees can cause subcutaneous injection instead of intramuscular, leading to slower absorption of the medication. Angles greater than 90 degrees risk hitting bone or nerves, causing unnecessary pain or injury. Therefore, the correct angle for administering intramuscular injections in the ventrogluteal site is 90 degrees.

3. A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?

• A. Apply warm compresses to the mouth
• B. Rinse mouth with alcohol-free mouthwash
• C. Increase fluid intake
• D. Clean the mouth gently with a soft toothbrush after meals

Correct answer: A

Rationale: The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.

4. A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication?

• A. Take the medication on an empty stomach to maximize absorption
• B. Notify your provider if your stool becomes dark green
• C. Decrease dietary fiber intake while taking this medication
• D. Take prescribed antacids at the same time as this medication

Correct answer: A

Rationale: The correct answer is A. The nurse should instruct clients to take iron on an empty stomach, 1 hour before meals to maximize absorption. This enhances the medication's effectiveness. Option B is incorrect because dark green stool is a common side effect of iron supplements and does not necessarily indicate a problem. Option C is incorrect as dietary fiber intake does not need to be decreased while taking iron supplements. Option D is incorrect because antacids can interfere with the absorption of iron and should not be taken at the same time.

5. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: The correct answer is A: Asthma. Clients with asthma should avoid Beta2 Blockade agents like propranolol as they can lead to bronchoconstriction, potentially worsening asthma symptoms. Choice B, hypertension, is not a contraindication for propranolol; in fact, it is commonly prescribed for hypertension. Choice C, tachydysrhythmias, is often an indication for propranolol due to its antiarrhythmic properties. Choice D, urolithiasis, does not directly impact the use of propranolol.

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