Nursing Elites

1. A client is being monitored while receiving bethanechol chloride (Urecholine) for urinary retention. Which of the following indicates a therapeutic effect of this medication?

• A. Increased heart rate
• B. Increased peristalsis
• C. Passage of flatus
• D. Urinary output of 50 mL per hour

Correct answer: D

Rationale: Bethanechol chloride (Urecholine) is administered to stimulate the bladder and treat urinary retention. The therapeutic effect is indicated by an increased urinary output, as it demonstrates the medication's ability to prompt the bladder to empty. Increased heart rate and passage of flatus are unrelated to the therapeutic effects of bethanechol. Although bethanechol can increase peristalsis, the primary therapeutic goal is to address urinary retention.

2. A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:

• A. Telling the client not to take the medication with food
• B. Suggesting that the client taper the dose until taste returns to normal
• C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
• D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor

Correct answer: C

Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.

3. A healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?

• A. Pancreatitis
• B. Pharyngitis
• C. Tonic-clonic seizures
• D. Human immunodeficiency virus (HIV) infection

Correct answer: D

Rationale: Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.

4. When caring for a client with cancer receiving cisplatin, what adverse effects should the nurse monitor for? Select all that apply.

• A. Tinnitus
• B. Insomnia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: Cisplatin, a chemotherapy medication, can lead to various adverse effects, including ototoxicity manifesting as tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Therefore, the nurse should closely monitor for these side effects during the client's treatment.

5. A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?

• A. I need to watch for signs of infection.
• B. I need to discontinue the medication after 14 days of use.
• C. I can take the medication with meals to minimize nausea.
• D. I need to call the health care provider (HCP) if more than one dose is missed.

Correct answer: B

Rationale: Azathioprine is an immunosuppressant taken for life. Discontinuing the medication after 14 days is incorrect.

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