Nursing Elites

1. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

2. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and is experiencing muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers by increasing acetylcholine levels at the neuromuscular junction, thereby helping to restore muscle strength. Naloxone is an opioid antagonist used to reverse opioid effects, not neuromuscular blockade. Dantrolene is a skeletal muscle relaxant used to treat malignant hyperthermia or neuroleptic malignant syndrome, not to reverse neuromuscular blockade. Vecuronium is a nondepolarizing neuromuscular blocking agent, like the one the client received, and is not used to reverse its effects.

3. A client has a prescription for Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?

• A. Dry mouth
• B. Hypertension
• C. Excessive perspiration
• D. Fecal impaction

Correct answer: C

Rationale: The correct answer is C: Excessive perspiration. Bethanechol is a muscarinic agonist that stimulates muscarinic receptors. Activation of muscarinic receptors can lead to excessive perspiration (diaphoresis) due to increased cholinergic activity, affecting sweat glands. Dry mouth, hypertension, and fecal impaction are not typically associated with muscarinic stimulation. Dry mouth is more commonly associated with anticholinergic medications, hypertension can be a result of alpha-adrenergic stimulation, and fecal impaction is not a direct effect of muscarinic receptor activation.

4. A client has a new prescription for metronidazole. The client should avoid which of the following?

• A. Dairy products
• B. Alcohol
• C. Leafy green vegetables
• D. Grapefruit juice

Correct answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole to prevent a disulfiram-like reaction, which can cause symptoms such as nausea, vomiting, headache, and flushing. Alcohol can interact with metronidazole and lead to adverse effects. Choices A, C, and D are not typically contraindicated with metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole, unlike alcohol.

5. A nurse is providing teaching for a male client who has Schizophrenia and is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

• A. Add extra snacks to your diet to prevent weight loss.
• B. Notify the provider if you develop breast enlargement.
• C. You may begin to have mild seizures while taking this medication.
• D. This medication is likely to increase your libido.

Correct answer: B

Rationale: The correct answer is B: 'Notify the provider if you develop breast enlargement.' Gynecomastia (breast enlargement) and galactorrhea can occur due to an increase in prolactin levels while taking risperidone. The client should inform the provider if these manifestations occur. Choices A, C, and D are incorrect. Adding extra snacks to the diet to prevent weight loss is not a specific instruction related to risperidone. Seizures are not a common side effect of risperidone, so the statement about mild seizures is inaccurate. Risperidone is more likely to cause sexual side effects like erectile dysfunction rather than increasing libido, making choice D incorrect.

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