Nursing Elites

1. A client has a new prescription for Bisacodyl. Which of the following statements should the nurse include?

• A. Take the medication before bedtime.
• B. Expect a rapid heart rate.
• C. Increase your intake of high-sodium foods.
• D. Expect rectal burning with the suppository form.

Correct answer: D

Rationale: The correct statement to include when educating a client about Bisacodyl is to expect rectal burning with the suppository form. Bisacodyl, a stimulant laxative, is known to cause rectal burning when administered as a suppository. This side effect is common and expected, and it is important for the client to be aware of it to prevent unnecessary alarm or concern. Choices A, B, and C are incorrect. Taking Bisacodyl before bedtime is not a common instruction; expecting a rapid heart rate is not a typical side effect of Bisacodyl; and increasing intake of high-sodium foods is not related to the use of Bisacodyl.

2. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?

• A. Vitamin K1
• B. Protamine
• C. Omeprazole
• D. Probenecid

Correct answer: C

Rationale: Omeprazole or another proton pump inhibitor is commonly prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help alleviate these symptoms by reducing gastric acid secretion, which can contribute to gastrointestinal discomfort. Vitamin K1 is not indicated for adverse effects of dabigatran. Protamine is used to reverse the anticoagulant effects of heparin, not dabigatran. Probenecid is not typically used to treat adverse effects of dabigatran.

3. Which of the following is the antidote for benzodiazepine toxicity?

• A. Flumazenil
• B. Methylene blue
• C. Deferoxamine
• D. Alkalinize urine

Correct answer: A

Rationale: Flumazenil is the specific antidote for benzodiazepine toxicity. It acts as a competitive antagonist at the benzodiazepine binding site on the GABA receptor, reversing the sedative effects of benzodiazepines. Administration of flumazenil is indicated in cases of benzodiazepine overdose or toxicity to rapidly reverse the central nervous system depression caused by these drugs. It is important to note that flumazenil should be used cautiously in patients with a history of seizures or those who are physically dependent on benzodiazepines, as it can precipitate withdrawal symptoms or seizures.

4. Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?

• A. 45 minutes to 18 hours
• B. 30 minutes to 12 hours
• C. 90 minutes to 36 hours
• D. 60 minutes to 24 hours

Correct answer: B

Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.

5. A client has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

• A. I will clean the site with an alcohol swab before applying the patch.
• B. I will rotate the application sites weekly.
• C. I will apply the patch to an area of skin with no hair.
• D. I will place the new patch where the old patch was.

Correct answer: C

Rationale: The correct answer is C because applying the patch to an area of skin without hair ensures better absorption of the medication. Hair can interfere with the patch's adherence and effectiveness. It is important for the client to choose a clean, hairless area for proper medication delivery. Choices A, B, and D are incorrect. Cleaning the site with an alcohol swab is a good practice but does not specifically indicate understanding of proper patch application. Rotating application sites weekly is important to prevent skin irritation but is not directly related to applying the patch to an area of skin without hair. Placing the new patch where the old patch was may lead to skin irritation and poor absorption of the medication.

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