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. Meperidine hydrochloride (Demerol) is prescribed for a client with pain. Which of the following would the nurse monitor for as a side effect of this medication?

• A. Diarrhea
• B. Bradycardia
• C. Hypertension
• D. Urinary retention

Correct answer: D

Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic that can cause various side effects. Common side effects include respiratory depression, orthostatic hypotension, tachycardia, drowsiness, constipation, and urinary retention. Diarrhea is not a common side effect of Meperidine hydrochloride. Bradycardia and hypertension are not typically associated with this medication. Therefore, the nurse should monitor for urinary retention as a potential side effect of Meperidine hydrochloride.

3. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:

• A. Should always be taken with food or antacids
• B. Should be double-dosed if one dose is forgotten
• C. Causes orange discoloration of sweat, tears, urine, and feces
• D. May not be discontinued independently if symptoms are gone in 3 months

Correct answer: C

Rationale: Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.

4. A client is instructed to take levothyroxine (Synthroid). The medication should be taken:

• A. With food
• B. At lunchtime
• C. On an empty stomach
• D. At bedtime with a snack

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach to enhance absorption. Taking it with food or at bedtime can interfere with its absorption, reducing its effectiveness. Therefore, it is essential for the client to take levothyroxine on an empty stomach to ensure optimal therapeutic outcomes.

5. A client is taking levothyroxine (Synthroid) for hypothyroidism. Which symptom would indicate to the nurse that the client is taking too much medication?

• A. Bradycardia
• B. Lethargy
• C. Tremors
• D. Constipation

Correct answer: C

Rationale: When a client is taking an excessive dose of levothyroxine (Synthroid), it can lead to symptoms of hyperthyroidism. Tremors are a common sign of excessive medication, along with tachycardia and insomnia. Bradycardia, lethargy, and constipation are typical symptoms of hypothyroidism, indicating that the client may require a higher dose of levothyroxine rather than too much.

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