Nursing Elites

1. A client has a prescription for Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?

• A. Dry mouth
• B. Hypertension
• C. Excessive perspiration
• D. Fecal impaction

Correct answer: C

Rationale: The correct answer is C: Excessive perspiration. Bethanechol is a muscarinic agonist that stimulates muscarinic receptors. Activation of muscarinic receptors can lead to excessive perspiration (diaphoresis) due to increased cholinergic activity, affecting sweat glands. Dry mouth, hypertension, and fecal impaction are not typically associated with muscarinic stimulation. Dry mouth is more commonly associated with anticholinergic medications, hypertension can be a result of alpha-adrenergic stimulation, and fecal impaction is not a direct effect of muscarinic receptor activation.

2. A client is being discharged with a new prescription for Lisinopril. Which of the following instructions should be included by the healthcare provider?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it's essential to avoid salt substitutes that may contain potassium which can further elevate potassium levels. Choice B is incorrect because Lisinopril is typically taken once daily in the morning, not at bedtime. Choice C is incorrect as increasing potassium intake can exacerbate hyperkalemia when taking Lisinopril. Choice D is incorrect as Lisinopril is usually taken on an empty stomach, not with food.

3. A client has a prescription for Amoxicillin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Avoid taking the medication with milk.
• C. Expect your stools to turn clay-colored.
• D. Complete the entire course of therapy.

Correct answer: D

Rationale: The correct answer is D: Complete the entire course of therapy. It is crucial for clients to complete the entire course of amoxicillin therapy to ensure the infection is fully treated and to prevent antibiotic resistance. Prematurely stopping the antibiotic can lead to incomplete eradication of the infection, potentially causing it to return and be more difficult to treat. Choices A and B are not specific to amoxicillin and are general medication administration instructions. Choice C is not a common side effect of amoxicillin and does not require patient education.

4. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain is not relieved after 5 minutes, the client should call 911 and take a second tablet. Taking more than the recommended dose can lead to serious side effects, and swallowing the tablet would not provide the rapid effect needed in cases of chest pain. Choice A is correct because it aligns with the standard protocol for nitroglycerin use in treating angina. Choice B is incorrect as the second tablet should be taken after 5 minutes, not 10 minutes. Choice C is incorrect as taking up to five tablets in 15 minutes is excessive and can result in serious complications. Choice D is incorrect as nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not swallowed.

5. A client has a prescription for ceftriaxone. Which of the following information should the nurse include in the teaching?

• A. You may develop a cough while taking this medication.
• B. You should stop taking this medication if you develop a rash.
• C. This medication cannot be given orally.
• D. This medication may cause your urine to turn yellow.

Correct answer: B

Rationale: The correct answer is B. A rash can indicate an allergic reaction to ceftriaxone, which should be reported to the provider. It is crucial to instruct the client to discontinue the medication and seek medical attention if a rash develops to prevent potential serious adverse effects. Choices A, C, and D are incorrect because cough is not a common side effect of ceftriaxone, ceftriaxone is typically administered parenterally, and a yellow discoloration of urine is a harmless side effect due to the color of the medication itself, respectively.

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