Nursing Elites

1. What information will the nurse provide when counseling a patient starting a sulfonamide drug for a urinary tract infection?

• A. Drink several quarts of water daily.
• B. If stomach upset occurs, avoid taking antacids.
• C. Limit sun exposure to avoid skin reactions.
• D. Report any sore throat promptly.

Correct answer: A

Rationale: The correct answer is A: Drink several quarts of water daily. This advice aims to prevent crystalluria, a potential side effect of sulfonamide drugs. Option B is incorrect because antacids should not be taken with sulfonamides as they can decrease drug absorption. Option C is incorrect as sulfonamides can increase sensitivity to sunlight, not requiring sun exposure limitations but sun protection measures. Option D is incorrect because a sore throat could indicate a more serious adverse effect and should be promptly reported for evaluation.

2. A client with a history of calcium phosphate urinary stones is being taught by a nurse. Which statements should the nurse include in this client’s dietary teaching? (Select all that apply.)

• A. Limit your intake of food high in animal protein.
• B. Read food labels to help minimize your sodium intake.
• C. A and B
• D. Reduce your intake of milk and other dairy products.

Correct answer: C

Rationale: For a client with a history of calcium phosphate urinary stones, it is essential to limit the intake of foods high in animal protein to prevent the formation of stones. Additionally, reducing sodium intake is crucial as high sodium levels can contribute to stone formation. Therefore, choices A and B are correct. Choice D, which suggests reducing intake of milk and other dairy products, is not specifically recommended for calcium phosphate stones. Clients with calcium phosphate stones should focus on limiting animal protein, sodium, and calcium intake. Choices A and B address these dietary modifications, making them the correct options for this client. Choices D, which is not directly related to calcium phosphate stones, is incorrect.

3. When monitoring a client who is receiving tissue plasminogen activator (t-PA), the nurse should have resuscitation equipment available because reperfusion of the cardiac tissue can result in which of the following?

• A. Cardiac arrhythmias.
• B. Hypertension.
• C. Seizures.
• D. Hypothermia.

Correct answer: A

Rationale: The correct answer is A: Cardiac arrhythmias. Reperfusion of cardiac tissue following t-PA administration can lead to cardiac arrhythmias, necessitating resuscitation equipment. Hypertension (choice B) is a common side effect of t-PA but is not directly related to reperfusion. Seizures (choice C) and hypothermia (choice D) are not typically associated with reperfusion from t-PA administration.

4. The patient is receiving acetazolamide (Diamox) for metabolic alkalosis and fluid overload. After taking the medication, the patient complains of right-sided flank pain. The nurse suspects that the patient has developed which condition?

• A. Gout
• B. Hemolytic anemia
• C. Metabolic acidosis
• D. Renal calculi

Correct answer: D

Rationale: The correct answer is D: Renal calculi. Acetazolamide, a carbonic anhydrase inhibitor, can lead to electrolyte imbalances and the formation of renal calculi. Right-sided flank pain is a classic symptom of renal calculi. Choices A, B, and C are incorrect. Gout is not typically associated with acetazolamide use. Hemolytic anemia and metabolic acidosis are not commonly linked to acetazolamide-induced side effects. Therefore, the patient's symptoms align more closely with the development of renal calculi.

5. Alteplase recombinant, or tissue plasminogen activator (t-PA), a thrombolytic enzyme, is administered during the first 6 hours after onset of myocardial infarction (MI) to:

• A. Control chest pain.
• B. Reduce coronary artery vasospasm.
• C. Control the arrhythmias associated with MI.
• D. Revascularize the blocked coronary artery.

Correct answer: D

Rationale: Alteplase recombinant, or t-PA, is a thrombolytic enzyme used to dissolve clots and revascularize the blocked coronary artery in patients experiencing a myocardial infarction (MI). Administering t-PA within the first 6 hours of MI onset is crucial to restore blood flow to the affected area and minimize cardiac tissue damage. Therefore, the correct answer is to revascularize the blocked coronary artery. Choices A, B, and C are incorrect because while controlling chest pain, reducing coronary artery vasospasm, and managing arrhythmias are important goals in managing MI, the primary purpose of administering t-PA within the first 6 hours is to restore blood flow by dissolving clots and revascularizing the blocked coronary artery.

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