Nursing Elites

1. 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.

2. A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?

• A. The development of complaints of insomnia
• B. The development of audible expiratory wheezes
• C. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
• D. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication

Correct answer: B

Rationale: The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.

3. 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.

4. A client with hypertension is prescribed clonidine (Catapres) transdermal patch. Which statement by the client indicates an understanding of the medication?

• A. I should change the patch daily.
• B. I should remove the old patch before applying a new one.
• C. I should avoid alcohol consumption while using this patch.
• D. I should apply the patch to different sites each time.

Correct answer: B

Rationale: The correct answer is B. The client should remove the old clonidine (Catapres) patch before applying a new one to prevent overdose. The patch is typically changed every 7 days. Avoiding alcohol consumption is important as it can potentiate the sedative effects of clonidine. It is recommended to rotate application sites to prevent skin irritation and ensure optimal drug absorption.

5. 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.

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