Nursing Elites

1. A client with end-stage cancer receiving Morphine has been prescribed Methylnaltrexone. The client's daughter asks about the purpose of Methylnaltrexone. Which response should the nurse provide?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: Methylnaltrexone is an opioid antagonist used to treat severe constipation unresponsive to laxatives in opioid-dependent clients. It functions by blocking the mu opioid receptors in the gastrointestinal tract, helping alleviate constipation associated with opioid use. Choices A, B, and D are incorrect. Methylnaltrexone does not increase respirations, prevent dependence on Morphine, or work with Morphine to increase pain relief; its primary purpose is to relieve opioid-induced constipation.

2. A client has a new prescription for Metoprolol. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Avoid sudden discontinuation of the medication.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Metoprolol. Metoprolol is a beta-blocker that should be tapered off gradually to prevent rebound hypertension and other cardiac issues. Abruptly stopping Metoprolol can lead to serious complications, so it is essential for the client to follow the healthcare provider's guidance on discontinuation. Choice A is incorrect because Metoprolol can be taken with or without food. Choice B is incorrect as Metoprolol is not typically associated with causing hyperglycemia. Choice D is also incorrect as there is no need to increase potassium-rich foods specifically due to taking Metoprolol.

3. When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Expect the development of a mild rash.
• B. Take the medication on an empty stomach.
• C. Monitor for signs of gingival hyperplasia.
• D. Increase your intake of calcium.

Correct answer: C

Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.

4. A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?

• A. Sodium 140 mEq/L
• B. Potassium 4.5 mEq/L
• C. BUN 55 mg/dL
• D. Glucose 120 mg/dL

Correct answer: C

Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.

5. A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?

• A. Hypokalemia
• B. Hypertension
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: Hydrochlorothiazide is a diuretic that can cause potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial to prevent potential adverse effects such as cardiac arrhythmias and muscle weakness.

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