Nursing Elites

1. A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.

2. When assessing a client taking Gemfibrozil, which of the following findings should the nurse identify as an adverse reaction to the medication?

• A. Mental status changes
• B. Tremor
• C. Jaundice
• D. Pneumonia

Correct answer: C

Rationale: Jaundice is an adverse reaction that can occur in clients taking Gemfibrozil due to the potential development of liver impairment. Other symptoms of liver impairment may include anorexia and upper abdominal discomfort. Monitoring for signs of jaundice is crucial to detect and manage adverse effects of the medication promptly. Mental status changes (choice A) are not commonly associated with Gemfibrozil use. Tremor (choice B) is not a typical adverse reaction of Gemfibrozil. Pneumonia (choice D) is not directly linked to Gemfibrozil use but can be a complication in some cases.

3. A client has been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

4. When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Expect the development of a mild rash.
• B. Take the medication on an empty stomach.
• C. Monitor for signs of gingival hyperplasia.
• D. Increase your intake of calcium.

Correct answer: C

Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.

5. A client with HIV-1 infection is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Cardiac dysrhythmia
• B. Metabolic alkalosis
• C. Renal failure
• D. Aplastic anemia

Correct answer: D

Rationale: Corrected Rationale: Zidovudine is associated with the development of aplastic anemia, a serious adverse effect characterized by bone marrow suppression. Regular monitoring is essential to detect this side effect early and prevent complications. Cardiac dysrhythmia, metabolic alkalosis, and renal failure are not commonly associated with zidovudine use, making them incorrect choices for adverse effects of this medication.

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