Nursing Elites

1. A client with Subacute Bacterial Endocarditis is receiving Streptomycin IM among other antibiotics. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

• A. Extremity paresthesias
• B. Urinary retention
• C. Severe constipation
• D. Complex partial seizures

Correct answer: A

Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly. Choices B, C, and D are incorrect because urinary retention, severe constipation, and complex partial seizures are not commonly associated adverse effects of Streptomycin.

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

• A. Expect to take this medication long-term.
• B. Increase fluid intake during therapy.
• C. Avoid sexual contact while on this medication.
• D. Consult your healthcare provider if you experience nausea.

Correct answer: B

Rationale: The correct instruction for a client taking Acyclovir is to increase fluid intake during therapy. Acyclovir can cause nephrotoxicity, potentially leading to kidney damage. Increasing fluid intake helps prevent this adverse effect by promoting adequate renal function and drug elimination. Choices A, C, and D are incorrect. Acyclovir is usually prescribed for short-term use, there is no need to avoid sexual contact while on the medication, and nausea is not a common side effect that necessitates immediate consultation with a healthcare provider.

3. A client with a new prescription for Escitalopram for the treatment of generalized anxiety disorder is being taught by a healthcare provider. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication on an empty stomach.
• B. I will follow a low-sodium diet while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I should not crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. This gradual reduction helps minimize potential withdrawal symptoms and ensures a safer discontinuation process. Choices A, B, and D are incorrect because taking escitalopram on an empty stomach, following a low-sodium diet, and not crushing the medication are not directly related to the safe and effective use of the medication or its discontinuation process.

4. A healthcare provider is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare provider to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction. Choices A, C, and D are important aspects of transfusion safety but are not directly related to preventing acute hemolytic reactions. Ensuring a patent IV line, monitoring vital signs, and staying with the client are all essential during transfusion but do not specifically address the risk of ABO or Rh incompatibility reactions.

5. A healthcare provider is preparing to administer metoprolol to a client. Which of the following findings should the provider identify as a contraindication to receiving this medication?

• A. Bradycardia
• B. Hypertension
• C. Fever
• D. Rash

Correct answer: A

Rationale: Metoprolol, a beta-blocker, is contraindicated in clients with bradycardia as it can further lower the heart rate, potentially leading to more serious complications. Bradycardia is defined as a heart rate below 60 beats per minute, and administering metoprolol in such cases can exacerbate this condition, causing adverse effects on cardiac output. Hypertension, fever, and rash are not contraindications for metoprolol administration.

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