Nursing Elites

1. What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?

• A. Obtain a clean-catch urine specimen.
• B. Assess the urine pH for acidity.
• C. Insert an indwelling catheter.
• D. Assess for complaints of dysuria.

Correct answer: A

Rationale: The correct answer is to obtain a clean-catch urine specimen. Before administering ampicillin to a client with a urinary tract infection, it is crucial to collect a urine specimen to determine the causative organism and evaluate the effectiveness of pharmacological therapy. Assessing the urine pH for acidity (choice B) is not the primary intervention needed before administering ampicillin. Inserting an indwelling catheter (choice C) is invasive and not necessary unless indicated for specific reasons. Assessing for complaints of dysuria (choice D) is important but does not take precedence over obtaining a urine specimen for proper diagnosis and treatment.

2. What information should the practical nurse provide to a female client who started taking an oral sulfonamide for a urinary tract infection the previous day and reports slight anorexia, while also experiencing urinary frequency?

• A. Take the medication with an antacid instead of cranberry juice to reduce the anorexia.
• B. Continue to take the medication with a sip of cranberry juice, restricting fluids until the frequency is controlled.
• C. Continue to drink cranberry juice, but take the medicine on an empty stomach with a full glass of water.
• D. Take the medication with a spoonful of ice cream or applesauce and avoid drinking cranberry juice.

Correct answer: C

Rationale: The practical nurse should advise the client to take sulfonamides with a full glass of water to help prevent crystalluria. It is essential to take the medication on an empty stomach, ideally 1 hour before eating or 2 hours after eating to maximize its absorption and effectiveness. Continuing to drink cranberry juice is beneficial, but it is important to take the medicine separately to enhance its therapeutic action.

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

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

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Fluvoxamine is known to cause drowsiness as a potential side effect. Patients should be advised to avoid activities like driving that require alertness until they understand how the medication affects them. Dry mouth, insomnia, and headache are potential side effects of other medications used for anxiety disorders but are not typically associated with fluvoxamine.

4. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?

• A. Increased appetite
• B. Dry mouth and increased thirst
• C. Tremors and polyuria
• D. Constipation

Correct answer: B

Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.

5. A client with a diagnosis of bipolar disorder is prescribed lamotrigine. The nurse should monitor for which potential adverse effect?

• A. Rash
• B. Tremors
• C. Hair loss
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Rash. Lamotrigine can cause a rash, which may indicate a serious adverse effect like Stevens-Johnson syndrome. Monitoring for a rash is crucial in clients taking lamotrigine to promptly address any potential severe reactions.

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