Nursing Elites

1. Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?

• A. Pallor
• B. Drowsiness
• C. Bradycardia
• D. Restlessness

Correct answer: D

Rationale: Signs of toxicity related to oxybutynin chloride (Ditropan XL) include central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity may include hypotension or hypertension, confusion, tachycardia, a flushed or red face, and signs of respiratory depression. Restlessness is a sign of central nervous system excitation, which can indicate a possible toxic effect of this medication.

2. A client who has been taking isoniazid (INH) for tuberculosis asks the nurse about the medication. Which statement by the client indicates the need for further teaching?

• A. I should limit my alcohol intake.
• B. I should notify my doctor if I notice a yellowish skin color.
• C. I should take the medication with an empty stomach.
• D. I should notify my doctor if I experience numbness and tingling in my extremities.

Correct answer: C

Rationale: Isoniazid (INH) is best absorbed when taken on an empty stomach. However, if gastrointestinal upset occurs, it can be taken with food. Limiting alcohol intake, monitoring for jaundice, and notifying the doctor of peripheral neuropathy symptoms are all appropriate actions while taking INH.

3. A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?

• A. Take the medication with a full glass of water.
• B. Increase your intake of purine-rich foods.
• C. Stop taking the medication if you experience a gout attack.
• D. Take the medication with or without food.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.

4. The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

• A. Diarrhea
• B. Heartburn
• C. Flatulence
• D. Constipation

Correct answer: B

Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.

5. A health care provider (HCP) writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to:

• A. Count the radial and carotid pulses every morning.
• B. Check the blood pressure every morning and evening.
• C. Stop taking the medication if the pulse is higher than 100 beats per minute.
• D. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.

Correct answer: D

Rationale: When taking digoxin, monitoring the pulse rate is essential due to its potential effects on heart rate. Digoxin can lead to bradycardia, where the pulse rate drops significantly. Withholding the medication and promptly contacting the healthcare provider if the pulse falls below 60 beats per minute is crucial to prevent severe complications and ensure appropriate management. Choices A, B, and C are incorrect because counting radial and carotid pulses, checking blood pressure, or stopping the medication based on a pulse rate higher than 100 beats per minute are not the primary monitoring parameters for a client taking digoxin.

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