Nursing Elites

1. A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:

• A. Watch for irritability as a side effect.
• B. Take the tablet with a full glass of water.
• C. Take an extra dose if the cough is accompanied by fever.
• D. Crush the sustained-release tablet if immediate relief is needed.

Correct answer: B

Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.

2. Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:

• A. Increase DNA and RNA synthesis.
• B. Promote the biosynthesis of nucleic acids.
• C. Increase estrogen concentration and estrogen response.
• D. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.

Correct answer: D

Rationale: The primary action of tamoxifen, an antineoplastic medication used in metastatic breast carcinoma, is to compete with estradiol for binding to estrogen receptors in tissues with high receptor concentrations. By doing so, tamoxifen reduces DNA synthesis and estrogen response, leading to its therapeutic effect in inhibiting the growth of estrogen-sensitive breast cancer cells.

3. A client has been prescribed furosemide (Lasix), and the nurse is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect? Select one that doesn't apply.

• A. Nausea
• B. Tinnitus
• C. Hypotension
• D. Hypokalemia

Correct answer: A

Rationale: Furosemide is a loop diuretic that can lead to adverse effects such as tinnitus, hypotension, and hypokalemia. While nausea is a common side effect of many medications, it is not typically associated with furosemide. Therefore, the nurse should recognize nausea as a potential adverse effect that doesn't apply to furosemide.

4. A client is receiving intravenous heparin for a deep vein thrombosis. The healthcare provider should monitor the client for which of the following potential complications?

• A. Hypertension
• B. Tachycardia
• C. Bleeding
• D. Hyperkalemia

Correct answer: C

Rationale: Heparin is an anticoagulant, so the primary potential complication is bleeding. The healthcare provider should monitor the client for signs of bleeding, such as bruising, hematuria, and gastrointestinal bleeding. Hypertension, tachycardia, and hyperkalemia are not direct complications of heparin therapy. Therefore, the correct answer is bleeding, as it is the most significant risk associated with heparin administration.

5. A client taking ethambutol (Myambutol) understands the instructions provided by the nurse if the client states that he or she will immediately report:

• A. Impaired sense of hearing
• B. Problems with visual acuity
• C. Gastrointestinal (GI) side effects
• D. Orange-red discoloration of body secretions

Correct answer: B

Rationale: The correct answer is B: Problems with visual acuity. Ethambutol is known to cause optic neuritis, leading to a decrease in visual acuity and color discrimination. Therefore, any visual changes should be reported promptly to prevent further complications. Choices A, C, and D are incorrect because ethambutol does not typically cause impaired sense of hearing, gastrointestinal side effects, or orange-red discoloration of body secretions. It is crucial for clients taking ethambutol to be aware of potential visual disturbances and report them promptly to healthcare providers.

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