Nursing Elites

1. A client taking long-term steroids also has ranitidine prescribed. The nurse provides which explanation as to why these drugs are given together?

• A. Ranitidine reduces the risk of ulcers associated with steroids.
• B. Ranitidine decreases the risk of infection associated with steroids.
• C. Ranitidine decreases blood sugar elevations associated with steroids.
• D. Ranitidine reduces sodium retention associated with steroid usage.

Correct answer: A

Rationale: The correct answer is A. Ranitidine is prescribed with long-term steroids to reduce the risk of ulcers associated with steroid therapy. Although steroids can increase the risk of ulcers due to their effect on the gastrointestinal system, ranitidine works by reducing stomach acid production, thus helping to prevent ulcer formation. Choices B, C, and D are incorrect as ranitidine is not given to decrease the risk of infection, reduce blood sugar elevations, or reduce sodium retention associated with steroid usage.

2. A client is prescribed verapamil for hypertension. The nurse should monitor the client for which common adverse effect?

• A. Constipation
• B. Headache
• C. Muscle cramping
• D. Fatigue

Correct answer: A

Rationale: Verapamil, a calcium channel blocker commonly used for hypertension, is known to cause constipation as a frequent adverse effect. This occurs due to its effects on smooth muscle relaxation in the gastrointestinal tract, leading to decreased motility. Headache, muscle cramping, and fatigue are not typically associated with verapamil use and are less common side effects. Therefore, the nurse should closely monitor the client for symptoms of constipation when administering verapamil.

3. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?

• A. Stimulant laxatives
• B. Bulk-forming laxatives
• C. Emollient laxatives
• D. Hyperosmotic laxatives

Correct answer: B

Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.

4. A client with a history of seizures is prescribed valproic acid. The nurse should monitor for which potential adverse effect?

• A. Liver toxicity
• B. Kidney stones
• C. Weight gain
• D. Pancreatitis

Correct answer: A

Rationale: Corrected Valproic acid is known to cause liver toxicity as a potential adverse effect. Regular monitoring of liver function tests is crucial to detect any signs of liver damage early on and prevent serious complications. Kidney stones, weight gain, and pancreatitis are not typically associated with valproic acid use, making them incorrect choices in this scenario.

5. A client with a diagnosis of depression is prescribed escitalopram. Which statement by the client indicates the need for further teaching?

• A. I should take this medication in the morning with food.
• B. This medication may take 1 to 4 weeks to notice improvement in symptoms.
• C. I can stop taking this medication once I feel better.
• D. This medication might make me feel drowsy.

Correct answer: C

Rationale: It is crucial for clients to understand that they should not discontinue escitalopram abruptly, even if they start feeling better. Stopping the medication suddenly can lead to withdrawal symptoms or a relapse of depression. It is essential to complete the full course of treatment as prescribed by the healthcare provider to ensure the best outcomes and prevent potential complications.

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