Nursing Elites

1. A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?

• A. Taking four medications decreases the risk of a severe allergic reaction.
• B. Taking four medications reduces the chance that the bacteria will become resistant.
• C. Taking four medications reduces the risk of adverse reactions.
• D. Taking four medications decreases the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: When treating tuberculosis, using a combination of multiple medications is crucial to reduce the risk of bacterial resistance. The use of four medications helps to target the bacteria from different angles, making it harder for them to develop resistance to the treatment. This approach is essential to ensure the effectiveness of the treatment regimen and to prevent the spread of drug-resistant strains of tuberculosis. Choices A, C, and D are incorrect because the primary reason for using multiple medications in tuberculosis treatment is to prevent the development of bacterial resistance, not to decrease the risk of allergic reactions, adverse reactions, or affecting the tuberculin skin test results.

2. Which of the following drugs is associated with the reaction of tendon dysfunction?

• A. Digitalis
• B. Niacin
• C. Tetracycline
• D. Fluoroquinolones

Correct answer: D

Rationale: Fluoroquinolones are known to be associated with tendon dysfunction or rupture. These drugs can weaken the tendons, leading to potential issues such as tendonitis or even tendon rupture. It is essential for healthcare providers to be cautious when prescribing fluoroquinolones, especially in patients who may be at higher risk for tendon-related complications.

3. When a nurse assesses a client's IV catheter insertion site and notes a hematoma, which of the following actions should the nurse take? (Select all that apply.)

• A. Stop the infusion.
• B. Apply alcohol to the insertion site.
• C. Apply warm compresses to the insertion site.
• D. Elevate the client's arm.

Correct answer: C

Rationale: When a nurse detects a hematoma at the IV catheter insertion site, applying warm compresses is beneficial as it can promote healing by enhancing circulation and reducing swelling. Elevating the client's arm helps in reducing edema, which can relieve pressure, pain, and further bleeding in the hematoma area. Stopping the infusion may be necessary in certain situations, but it is not a standard action for all hematoma cases. Applying alcohol to the insertion site is discouraged as it can cause irritation and may not aid in resolving the hematoma.

4. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause the accumulation of bradykinin, leading to cough. Monitoring for a persistent dry cough is crucial as it may indicate the need for further evaluation and possible medication adjustment. Choices B, C, and D are not typically associated with Enalapril use and are less likely to be monitored as adverse effects.

5. In which of the following cases is Lansoprazole not used?

• A. Gastritis
• B. Peptic Ulcers
• C. Zollinger-Ellison syndrome
• D. Thalamus hypertrophy

Correct answer: D

Rationale: Lansoprazole is a proton pump inhibitor mainly used to treat conditions related to the stomach, such as gastritis, peptic ulcers, and Zollinger-Ellison syndrome. Thalamus hypertrophy is not a condition that Lansoprazole is indicated for; it is used for gastrointestinal issues and not neurological conditions.

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