Nursing Elites

1. A nurse is monitoring a client receiving lithium carbonate for bipolar disorder. Which finding should the nurse report immediately to the healthcare provider?

• A. Increased thirst
• B. Fine hand tremors
• C. Frequent urination
• D. Persistent vomiting

Correct answer: D

Rationale: Persistent vomiting can be a sign of lithium toxicity, which requires immediate medical attention. Increased thirst, fine hand tremors, and frequent urination are common side effects of lithium.

2. Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?

• A. Gastric atony
• B. Urinary strictures
• C. Neurogenic atony
• D. Gastroesophageal reflux

Correct answer: B

Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications. Gastric atony, neurogenic atony, and gastroesophageal reflux are not contraindications for the administration of Bethanechol chloride for urinary retention.

3. A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse include in the teaching plan?

• A. Take the medication with meals.
• B. Monitor for signs of hypoglycemia.
• C. Avoid alcohol while taking this medication.
• D. Take the medication at bedtime.

Correct answer: C

Rationale: Clients taking metformin (Glucophage) should avoid alcohol as it can increase the risk of lactic acidosis. Metformin should be taken with meals to reduce gastrointestinal upset. While hypoglycemia is less common with metformin compared to other diabetes medications, clients should still be aware of its symptoms.

4. 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.

5. A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?

• A. Check the medication order for accuracy.
• B. Have an epinephrine injection available.
• C. Administer a test dose to check for a reaction.
• D. Ask the client about any allergies.

Correct answer: B

Rationale: When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.

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