Nursing Elites

1. A client is receiving meperidine (Demerol) for pain management. Which assessment finding requires immediate action?

• A. Constipation
• B. Drowsiness
• C. Respiratory rate of 10 breaths per minute
• D. Nausea

Correct answer: C

Rationale: A respiratory rate of 10 breaths per minute indicates respiratory depression, a severe side effect of meperidine (Demerol) that necessitates immediate intervention to prevent further complications. Constipation, drowsiness, and nausea are common but less urgent side effects that do not pose an immediate life-threatening risk. Respiratory depression can lead to respiratory arrest and must be addressed promptly to ensure the client's safety and well-being.

2. A nurse is monitoring a client receiving lithium carbonate for bipolar disorder. Which finding should the nurse report immediately to the healthcare provider?

• A. Increased thirst
• B. Fine hand tremors
• C. Frequent urination
• D. Persistent vomiting

Correct answer: D

Rationale: Persistent vomiting can be a sign of lithium toxicity, which requires immediate medical attention. Increased thirst, fine hand tremors, and frequent urination are common side effects of lithium.

3. Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history, knowing that this medication is contraindicated if which of the following disorders is present?

• A. Headaches
• B. Liver disease
• C. Hypothyroidism
• D. Diabetes mellitus

Correct answer: B

Rationale: Carbamazepine (Tegretol) is contraindicated in liver disease due to its potential to cause hepatic toxicity. Regular monitoring of liver function tests is necessary when using this medication to detect any signs of liver damage.

4. 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.

5. A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?

• A. Lung sounds
• B. Blood pressure
• C. Blood ammonia level
• D. Serum potassium level

Correct answer: C

Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.

Similar Questions