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 has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:

• A. Hypercalcemia
• B. Peripheral neuritis
• C. Small blood vessel spasm
• D. Impaired peripheral circulation

Correct answer: B

Rationale: The client's symptoms of numbness, paresthesias, and tingling in the extremities indicate peripheral neuritis, a common side effect of isoniazid (INH). This condition can be managed by supplementing with pyridoxine (vitamin B6) to minimize the symptoms.

3. When assessing the effectiveness of leflunomide (Arava) in a client with rheumatoid arthritis, which question should the nurse ask during data collection?

• A. Do you have any joint pain?
• B. Are you having any diarrhea?
• C. Do you have frequent headaches?
• D. Are you experiencing heartburn?

Correct answer: A

Rationale: To assess the effectiveness of leflunomide (Arava), a medication used to treat rheumatoid arthritis, the nurse should inquire about joint pain. Joint pain is a common symptom of rheumatoid arthritis, and improvement in joint pain indicates the medication's effectiveness in managing the condition.

4. A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client. The nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?

• A. I can take aspirin or my antihistamine if I need it.
• B. I need to take the medication every day at the same time.
• C. I need to avoid coffee, tea, cola, and chocolate in my diet.
• D. If I gain more than 5 pounds a week, I will call my doctor.

Correct answer: A

Rationale: Aspirin and other over-the-counter medications should not be taken without consulting the health care provider (HCP). The client needs to take the medication at the same time every day and avoid caffeine-containing foods and fluids to prevent steroid-ulcer development.

5. A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?

• A. Keep insulin vials refrigerated at all times.
• B. Rotate the insulin injection sites systematically.
• C. Increase the amount of insulin before unusual exercise.
• D. Monitor the urine acetone level to determine the insulin dosage.

Correct answer: B

Rationale: When a client is stabilized with daily insulin injections, it is crucial to rotate the injection sites systematically. This practice helps prevent the development of lipodystrophy, which can affect insulin absorption and lead to inconsistent glucose control. Additionally, rotating sites minimizes discomfort and tissue damage, ensuring optimal insulin delivery and effectiveness.

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