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 with diabetes mellitus visits a health care clinic. The client's diabetes mellitus was previously well controlled with daily glyburide (DiaBeta). However, the fasting blood glucose level has recently been in the range of 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• A. Prednisone
• B. Phenelzine (Nardil)
• C. Atenolol (Tenormin)
• D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone is known to reduce the effectiveness of oral hypoglycemic medications like glyburide and insulin, which can result in hyperglycemia. Therefore, the addition of prednisone to the client's regimen could have contributed to the elevated fasting blood glucose levels observed.

3. When a client is taking lansoprazole (Prevacid), which question should the nurse ask during data collection to determine medication effectiveness?

• A. Has your appetite increased?
• B. Are you experiencing any heartburn?
• C. Do you have any problems with vision?
• D. Do you experience any leg pain when walking?

Correct answer: B

Rationale: When a client is taking lansoprazole (Prevacid), a gastric acid pump inhibitor used to treat gastroesophageal reflux disease (GERD), the nurse should ask if the client is experiencing any heartburn to determine medication effectiveness. Heartburn is a common symptom of GERD, and the reduction of heartburn indicates the effectiveness of lansoprazole in managing acid reflux symptoms. Choices A, C, and D are not relevant to assessing the effectiveness of lansoprazole for GERD.

4. The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?

• A. Echocardiography
• B. Electrocardiography
• C. Cervical radiography
• D. Pulmonary function studies

Correct answer: D

Rationale: Bleomycin, when administered intravenously, can lead to interstitial pneumonitis and potentially progress to pulmonary fibrosis. Therefore, pulmonary function studies are essential to monitor lung function and detect any early signs of pulmonary toxicity. Other tests, such as regular pulmonary assessments, should also be conducted to ensure the safety and well-being of the client.

5. The healthcare provider is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the healthcare provider specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

• A. Anemia
• B. Decreased platelets
• C. Increased uric acid level
• D. Decreased leukocyte count

Correct answer: C

Rationale: Following chemotherapy for leukemias and lymphomas, hyperuricemia is common due to the massive cell kill. Chemotherapy leads to the rapid destruction of cancer cells, releasing large amounts of nucleic acids, which are broken down into uric acid. Monitoring and managing uric acid levels are crucial to prevent complications such as renal damage and gout.

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