Nursing Elites

1. When a patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium, the nurse should monitor for potential side effects. The correct answer is dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. This side effect can impact the patient's oral health and comfort, requiring close monitoring and appropriate interventions.

• A. Dry mouth
• B. Tachycardia
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: Ipratropium is an anticholinergic medication commonly used in COPD. One of the most common side effects of anticholinergics is dry mouth due to the inhibition of salivary gland function. Tachycardia (Choice B) is not a typical side effect of ipratropium. Insomnia (Choice C) is also not a common side effect of this medication. Increased appetite (Choice D) is not associated with ipratropium use. Therefore, the correct side effect to monitor for in a patient prescribed ipratropium is dry mouth.

2. The healthcare provider has prescribed an influenza vaccine for a 74-year-old client before discharge. Which client condition would prompt the practical nurse to consult with the charge nurse rather than administer the vaccine?

• A. History of congestive heart failure
• B. History of an egg allergy
• C. History of pneumococcal vaccination
• D. History of end-stage renal disease

Correct answer: B

Rationale: The correct answer is B: History of an egg allergy. The influenza vaccine may contain a small amount of egg protein. According to the CDC, individuals with a severe allergy to any component of the vaccine, including egg protein, should not receive the influenza vaccine. Therefore, if the client has a history of an allergy to eggs, the practical nurse should not administer the vaccine and consult with the charge nurse for further guidance, as it is a contraindication. The other conditions listed do not require consultation before administering the influenza vaccine.

3. A client with a history of atrial fibrillation is prescribed verapamil. The nurse should monitor for which potential side effect?

• A. Constipation
• B. Diarrhea
• C. Headache
• D. Hypotension

Correct answer: A

Rationale: Verapamil, a calcium channel blocker, can commonly cause constipation due to its effects on smooth muscle relaxation in the gastrointestinal tract. Therefore, monitoring for constipation is important when a client is prescribed verapamil.

4. 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.

5. A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?

• A. Avoid using artificial tears because they decrease the efficacy of cyclosporine.
• B. Discontinue the use of both products if transient blurring occurs after administration.
• C. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
• D. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level.

Correct answer: C

Rationale: The correct answer is to allow a 15-minute interval between the administration of cyclosporine and artificial tears. Cyclosporine, an ophthalmic emulsion that increases tear production, can be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. This interval helps to prevent any potential interactions between the two products and ensures optimal effectiveness of cyclosporine for treating dry eyes.

Similar Questions