Nursing Elites

1. A female client with tobacco use disorder is being educated by a nurse about Nicotine replacement therapy. Which of the following statements by the client shows understanding of the teaching?

• A. I should avoid eating right before I chew a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking if I become pregnant.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. The client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum. Choice B is incorrect because there is no specified timeline for stopping nicotine gum use. Choice C is incorrect because nicotine gum is not recommended during pregnancy. Choice D is incorrect as the client should chew the nicotine gum slowly for about 30 minutes, not quickly for 15 minutes.

2. A healthcare provider is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the provider monitor?

• A. Urinary retention
• B. Tachypnea
• C. Hypertension
• D. Irritating cough

Correct answer: A

Rationale: The correct answer is urinary retention. Opioid agonists like morphine can suppress the awareness of bladder fullness, leading to urinary retention. This complication can result in significant discomfort and potential urinary tract issues if not promptly addressed. Tachypnea (increased respiratory rate) is a common side effect of opioids but is not a specific complication related to urinary retention. Hypertension is not typically associated with opioid agonists and is more commonly seen with opioid antagonists. An irritating cough is not a known complication of opioid agonists and is not directly related to the effect opioids have on the urinary system.

3. A healthcare professional is monitoring a client who is receiving spironolactone. Which of the following findings should the professional report to the provider?

• A. Serum Sodium 144 mEq/L
• B. Urine output 120 mL in 4 hours
• C. Serum Potassium 5.2 mEq/L
• D. Blood Pressure 140/90 mm Hg

Correct answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia, which is a potentially dangerous condition. Spironolactone, a potassium-sparing diuretic, can cause potassium retention, leading to hyperkalemia. This electrolyte imbalance can result in serious consequences such as cardiac dysrhythmias. The healthcare professional should promptly report this finding to the provider, withhold the medication, and take appropriate actions to prevent complications. Monitoring and managing potassium levels are crucial in clients receiving spironolactone. The other options do not directly relate to the potential adverse effects of spironolactone and are within normal limits, making them less urgent to report.

4. A client has a new prescription for Nifedipine. Which of the following adverse effects should the nurse monitor?

• A. Hypertension
• B. Edema
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Edema. Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should closely observe the client's lower extremities for any signs of swelling, which could indicate the development of edema. Choice A, Hypertension, is incorrect because Nifedipine is used to treat hypertension, not cause it. Choice C, Hyperglycemia, is unrelated to Nifedipine's common adverse effects. Choice D, Bradycardia, is not typically associated with Nifedipine use.

5. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital has a long half-life of 4 days, meaning it remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should expect to administer phenobarbital once a day to maintain therapeutic levels and effectiveness. Administering it more than once a day would lead to unnecessary dosing and potential adverse effects as the medication remains active in the body for an extended period.

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