Nursing Elites

1. A healthcare provider is preparing to administer bisacodyl suppository to a client. Which of the following actions should the healthcare provider take?

• A. Don sterile gloves
• B. Lubricate index finger
• C. Use a rectal applicator for insertion
• D. Position client supine with knees bent

Correct answer: B

Rationale: The correct action when administering a bisacodyl suppository is to lubricate the index finger for easier insertion. Using a rectal applicator for insertion is not recommended for bisacodyl suppositories. Positioning the client supine with knees bent is not necessary for the administration of a bisacodyl suppository. While wearing gloves is important for infection control, sterile gloves are not required for this procedure.

2. A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?

• A. Notify your provider if you experience restlessness or spasms of the face or neck
• B. This medication can cause insomnia
• C. Decrease your fluid intake while taking this medication
• D. This medication can cause urinary frequency

Correct answer: A

Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can lead to extrapyramidal symptoms such as restlessness or facial spasms, which are serious and require immediate medical attention. Choices B, C, and D are incorrect. Insomnia is not a common side effect of metoclopramide. Increasing fluid intake is usually recommended to prevent dehydration caused by potential side effects like diarrhea. Urinary frequency is not a typical side effect associated with metoclopramide.

3. A client is prescribed digoxin 0.125 mg daily for heart failure. Which of the following client reports should concern the nurse as a sign of digoxin toxicity?

• A. Increased appetite
• B. Visual disturbances
• C. Weight gain
• D. Constipation

Correct answer: B

Rationale: Visual disturbances such as blurred vision or seeing halos around lights are common signs of digoxin toxicity. Increased appetite, weight gain, and constipation are not typically associated with digoxin toxicity. Weight gain could be a sign of worsening heart failure rather than digoxin toxicity. Increased appetite and constipation are not specific signs of digoxin toxicity and are less likely to be related.

4. A healthcare provider is reviewing the client's history before administering opioid pain medication. Which of the following conditions is a contraindication to opioid therapy?

• A. Asthma
• B. Renal failure
• C. Diabetes mellitus
• D. Obesity

Correct answer: B

Rationale: Renal failure is a contraindication to opioid therapy due to the risk of drug accumulation and toxicity. Asthma, diabetes mellitus, and obesity are not contraindications to opioid therapy. Asthma is a respiratory condition that can be managed alongside opioids, diabetes mellitus and obesity do not directly contraindicate opioid therapy.

5. A nurse is providing care to a client with staphylococcus epidermidis who is prescribed vancomycin. Identify the adverse effect associated with the antibiotic therapy.

• A. Hepatotoxicity
• B. Constipation
• C. Infusion reaction
• D. Immunosuppression

Correct answer: C

Rationale: The correct answer is C: Infusion reaction. Vancomycin can cause infusion reactions like 'Red Man Syndrome,' which involves rashes, flushing, tachycardia, and hypotension. Hepatotoxicity (choice A) is not a common adverse effect of vancomycin. Constipation (choice B) is not typically associated with vancomycin use. Immunosuppression (choice D) is not a direct adverse effect of vancomycin therapy.

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