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 home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?

• A. Constipation and bloating might be a problem.
• B. I'll continue to watch my diet and reduce my fats.
• C. Walking a mile each day will help the whole process.
• D. I'll continue my nicotinic acid from the health food store.

Correct answer: D

Rationale: Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels.

3. The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:

• A. Acne
• B. Eczema
• C. Hair loss
• D. Herpes simplex

Correct answer: A

Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.

4. Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?

• A. To take the medication after meals
• B. To return to the clinic weekly for serum drug-level testing
• C. To call the health care provider (HCP) if a skin rash occurs
• D. To restrict alcohol intake with this medication

Correct answer: B

Rationale: Cycloserine requires weekly serum drug level determinations to monitor for neurotoxicity. The medication must be taken after meals, and the client should avoid alcohol. Additionally, the client should report any signs of skin rash or central nervous system toxicity to the healthcare provider.

5. A client who has been taking isoniazid (INH) for tuberculosis asks the nurse about the medication. Which statement by the client indicates the need for further teaching?

• A. I should limit my alcohol intake.
• B. I should notify my doctor if I notice a yellowish skin color.
• C. I should take the medication with an empty stomach.
• D. I should notify my doctor if I experience numbness and tingling in my extremities.

Correct answer: C

Rationale: Isoniazid (INH) is best absorbed when taken on an empty stomach. However, if gastrointestinal upset occurs, it can be taken with food. Limiting alcohol intake, monitoring for jaundice, and notifying the doctor of peripheral neuropathy symptoms are all appropriate actions while taking INH.

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