Nursing Elites

1. In the management of nausea due to gastroparesis in a client with Diabetes, which of the following medications may be prescribed?

• A. Lubiprostone
• B. Metoclopramide
• C. Bisacodyl
• D. Loperamide

Correct answer: B

Rationale: Metoclopramide, as a dopamine antagonist, is commonly prescribed to manage nausea and improve gastric motility in clients with diabetic gastroparesis. By enhancing gastric emptying, it can help alleviate symptoms like bloating and nausea associated with gastroparesis. Choice A, Lubiprostone, is primarily used to treat chronic idiopathic constipation and irritable bowel syndrome with constipation, not nausea due to gastroparesis. Choice C, Bisacodyl, is a stimulant laxative used for the treatment of constipation and bowel preparation before procedures, not for nausea associated with gastroparesis. Choice D, Loperamide, is an antimotility agent used to manage diarrhea, not nausea or gastric motility issues seen in gastroparesis.

2. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

3. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

4. A client receives a new prescription for NRTIs for HIV treatment. Which statement should the nurse include during teaching about these medications?

• A. These medications work by inhibiting enzymes to prevent HIV replication.
• B. These medications work by preventing protein synthesis within the HIV cell.
• C. These medications work by weakening the cell wall of the HIV virus.
• D. These medications work by blocking HIV entry into cells.

Correct answer: A

Rationale: NRTIs inhibit the enzyme reverse transcriptase, essential for HIV replication. By preventing this process, viral replication is hindered, ultimately reducing the viral load in the body. Option A correctly explains the mechanism of action of NRTIs in treating HIV infection. Choices B, C, and D describe mechanisms of action that do not align with how NRTIs work in HIV treatment. B is incorrect because NRTIs do not target protein synthesis within the HIV cell. C is incorrect as NRTIs do not affect the cell wall of the HIV virus. D is incorrect because NRTIs do not block HIV entry into cells.

5. A client with tobacco use disorder is being educated about Nicotine replacement therapy. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid eating right before chewing a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking during pregnancy.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. To maximize the effectiveness of nicotine gum, the client should avoid eating or drinking 15 minutes before and while using it. This helps ensure proper absorption of nicotine through the oral mucosa. Choice B is incorrect because the duration of nicotine gum use can vary depending on the individual's needs and progress. Choice C is incorrect as nicotine gum should be used during pregnancy only under healthcare provider guidance. Choice D is incorrect because nicotine gum should be chewed slowly until a tingling sensation is felt, then parked between the cheek and gum until the tingling stops.

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