Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. The nurse should assess the client for which potential side effect?

• A. Nausea
• B. Dry mouth
• C. Cough
• D. Palpitations

Correct answer: B

Rationale: The correct answer is B: Dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. Anticholinergic medications like ipratropium can lead to decreased salivary flow, resulting in dry mouth. Choices A, C, and D are incorrect because nausea, cough, and palpitations are not commonly associated with ipratropium use.

2. A client is receiving heparin to treat a deep vein thrombosis. The nurse should monitor which laboratory result to assist in evaluating the efficacy of the drug?

• A. Platelet count
• B. Prothrombin time
• C. Partial thromboplastin time
• D. Serum levels of protamine sulfate

Correct answer: C

Rationale: The nurse should monitor the partial thromboplastin time to evaluate the efficacy of heparin. Partial thromboplastin time reflects the anticoagulant effect of heparin by measuring the intrinsic pathway of coagulation. Platelet count assesses platelet levels and is not specific to heparin efficacy. Prothrombin time is used to monitor warfarin therapy. Serum levels of protamine sulfate are not used to evaluate the efficacy of heparin.

3. A client undergoing hemodialysis for chronic kidney disease is taking the medication erythropoietin. The nurse should reinforce instructions to explain for which reason this medication is prescribed?

• A. This drug prevents infections associated with dialysis.
• B. This drug prevents deep vein thrombosis in older clients.
• C. This drug helps stimulate the production of red blood cells.
• D. This drug helps balance the level of phosphorus in the body.

Correct answer: C

Rationale: Erythropoietin is prescribed to stimulate the production of red blood cells. Clients undergoing hemodialysis often develop anemia due to end-stage renal disease. Erythropoietin helps correct this anemia by stimulating red blood cell production. It is not used to prevent infections associated with dialysis, prevent deep vein thrombosis, or balance phosphorus levels in the body.

4. A client whose seizure disorder has been managed with phenytoin is admitted to the emergency department with status epilepticus. Which drug should the practical nurse anticipate being prescribed for administration to treat these seizures?

• A. Phenytoin
• B. Diazepam
• C. Phenobarbital
• D. Carbamazepine

Correct answer: B

Rationale: In the management of status epilepticus, which is a life-threatening condition of prolonged seizures, rapid intervention is crucial. Diazepam is the drug of choice for treating status epilepticus due to its fast onset of action and effectiveness in stopping seizures. It acts by enhancing the inhibitory neurotransmitter GABA to suppress seizure activity quickly. Phenytoin, although used for long-term seizure control, has a slower onset of action and is not the first-line medication for managing status epilepticus.

5. 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.

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