Nursing Elites

1. Meperidine hydrochloride (Demerol) is prescribed for a client with pain. Which of the following would the nurse monitor for as a side effect of this medication?

• A. Diarrhea
• B. Bradycardia
• C. Hypertension
• D. Urinary retention

Correct answer: D

Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic that can cause various side effects. Common side effects include respiratory depression, orthostatic hypotension, tachycardia, drowsiness, constipation, and urinary retention. Diarrhea is not a common side effect of Meperidine hydrochloride. Bradycardia and hypertension are not typically associated with this medication. Therefore, the nurse should monitor for urinary retention as a potential side effect of Meperidine hydrochloride.

2. The healthcare provider is applying a topical corticosteroid to a client with eczema. The healthcare provider should monitor for the potential of increased systemic absorption of the medication if the medication were being applied to which of the following body areas?

• A. Back
• B. Axilla
• C. Soles of the feet
• D. Palms of the hands

Correct answer: B

Rationale: The axilla has thinner skin, making it more permeable to topical medications. Areas with thinner skin, like the axilla, allow for higher systemic absorption of topical corticosteroids.

3. A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?

• A. Apply the patch to a hairless area of skin.
• B. Leave the patch on for 24 hours.
• C. Apply the patch at the same time each day.
• D. You can keep the patch on while taking a shower.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching plan is to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day. This consistency helps maintain steady blood levels of the medication. While it is important to apply the patch to a hairless area of the skin for proper absorption, it does not necessarily have to be left on for 24 hours; typically, it is worn for 12-14 hours to allow for a nitrate-free period and reduce tolerance. Additionally, the patch can generally be kept on while taking a shower, as water exposure does not typically affect its efficacy.

4. Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?

• A. Neuralgia
• B. Insomnia
• C. Use of nitroglycerin
• D. Use of multivitamins

Correct answer: C

Rationale: The correct answer is C. Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide and is contraindicated with the concurrent use of organic nitrates and nitroglycerin. Using nitroglycerin together with Viagra can lead to severe hypotension and cardiovascular collapse, making it unsafe to combine both medications.

5. An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?

• A. Tremors
• B. Dizziness
• C. Confusion
• D. Hallucinations

Correct answer: C

Rationale: Older clients are particularly vulnerable to central nervous system side effects of cimetidine. The most frequent side effect is confusion. It is crucial for nurses to be vigilant in monitoring for confusion as it can impact the client's safety and well-being. While tremors, dizziness, and hallucinations are possible side effects, confusion is the most common in older clients taking cimetidine.

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