Nursing Elites

1. The practical nurse administers lactulose to a client. Which client outcome would indicate a therapeutic response?

• A. An increase in urine output
• B. Two to three soft stools per day
• C. Absence of nausea
• D. Decreased serum potassium

Correct answer: B

Rationale: Lactulose is a type of laxative that works by preventing the absorption of ammonia in the colon, leading to increased water absorption in the stool and softening of the stool. The therapeutic response to lactulose is indicated by the passage of two to three soft stools per day, showing that the medication is effectively promoting bowel movements.

2. A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?

• A. I will take one tablet every 5 minutes, up to three tablets.
• B. I should take one tablet at the onset of angina and stop activity.
• C. I need to replace nitroglycerin tablets every 3 to 6 months to maintain freshness.
• D. I should ensure that I chew the pill completely before swallowing it.

Correct answer: D

Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.

3. A client with a diagnosis of generalized anxiety disorder is prescribed buspirone. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct potential side effect of buspirone is drowsiness. It is important for clients to be informed about this side effect, as it can affect their ability to perform tasks that require full alertness, such as driving. Clients should be advised to avoid activities that require mental alertness until they know how the medication affects them. Dry mouth is a common side effect of some other medications used for anxiety, such as benzodiazepines. Nausea and headache are not typically associated with buspirone use.

4. A client with chronic kidney disease is prescribed sevelamer carbonate. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed sevelamer carbonate, the nurse should monitor for hypercalcemia as a potential side effect. Sevelamer carbonate can bind to dietary calcium and impair its absorption, potentially leading to elevated calcium levels in the blood. Monitoring calcium levels is crucial to detect and manage hypercalcemia promptly. Hypocalcemia (choice B) is incorrect because sevelamer carbonate's action is more likely to cause elevated calcium levels. Hyperkalemia (choice C) and hypokalemia (choice D) are related to potassium levels and are not typically associated with sevelamer carbonate use.

5. The healthcare provider is evaluating the effectiveness of metaproterenol for how do you know it's been effective?

• A. Increased heart rate and blood pressure
• B. Decreased white blood cell count
• C. Decreased wheezing upon auscultation
• D. Decreased respiratory rate

Correct answer: C

Rationale: The effectiveness of metaproterenol, a bronchodilator, is assessed by a decrease in wheezing upon auscultation. Wheezing indicates airway constriction, and a reduction in wheezing signifies improved airflow and bronchodilation due to the medication's action. Therefore, choices A, B, and D are incorrect as they do not directly relate to the expected outcome of metaproterenol therapy.

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