Nursing Elites

1. A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen?

• A. My ulcer will heal because these medications will kill the bacteria.
• B. These medications are only taken when I have pain from my ulcer.
• C. The medications will kill the bacteria and stop the acid production.
• D. These medications will coat the ulcer and decrease the acid production in my stomach.

Correct answer: C

Rationale: Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.

2. A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select one that doesn't apply.

• A. Nizatidine (Axid)
• B. Ranitidine (Zantac)
• C. Famotidine (Pepcid)
• D. Ibuprofen (Motrin)

Correct answer: D

Rationale: H2-receptor antagonists like Nizatidine, Ranitidine, and Famotidine are used to suppress gastric acid secretion, relieve heartburn symptoms, and prevent complications of peptic ulcer disease. Ibuprofen, on the other hand, is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, but it is not an H2-receptor antagonist. It is essential to differentiate between these medication classes to ensure appropriate treatment for gastrointestinal conditions.

3. A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:

• A. Treat thyroid storm.
• B. Prevent cardiac irritability.
• C. Treat hypocalcemic tetany.
• D. Stimulate the release of parathyroid hormone.

Correct answer: C

Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.

4. The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred?

• A. Hyperventilation
• B. Elevated blood pressure
• C. Local pain at the burn site
• D. Local rash at the burn site

Correct answer: A

Rationale: Hyperventilation is an indication of a systemic effect of mafenide acetate (Sulfamylon) due to its potential to cause acidosis by suppressing renal excretion of acid. If hyperventilation occurs, the medication should be discontinued to prevent further complications.

5. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

• A. Fever
• B. Diarrhea
• C. Complaints of nausea and vomiting
• D. Crackles on auscultation of the lungs

Correct answer: D

Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.

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