Nursing Elites

1. What class of laxative would the nurse recommend to a patient asking about the best way to prevent constipation?

• A. Stimulant laxatives
• B. Bulk-forming laxatives
• C. Emollient laxatives
• D. Hyperosmotic laxatives

Correct answer: B

Rationale: The correct answer is B: Bulk-forming laxatives. These laxatives are recommended to prevent constipation because they work by absorbing liquid in the intestines, forming a bulky, soft stool that is easier to pass. They are safe and considered the most natural option. Stimulant laxatives (choice A) work by promoting bowel movements through intestinal contractions and are more suitable for treating occasional constipation rather than preventing it. Emollient laxatives (choice C) soften the stool by increasing the incorporation of water into the feces and are more suitable for patients who need to avoid straining during defecation. Hyperosmotic laxatives (choice D) work by drawing water into the intestine through osmosis and are typically used for more severe cases of constipation, not for prevention.

2. The healthcare professional is caring for a patient with a new order for an oral laxative. Which is a contraindication in administering an oral laxative?

• A. Cardiac problems
• B. Abdominal pain of unknown origin
• C. Several hemorrhoids
• D. Chronic constipation

Correct answer: B

Rationale: Administering an oral laxative to a patient with abdominal pain of unknown origin is contraindicated because it could be a sign of a more serious underlying condition that needs immediate medical evaluation. Giving a laxative in such a situation without proper diagnosis could potentially worsen the patient's condition or delay appropriate treatment. Choice A (Cardiac problems) is not a contraindication for an oral laxative unless the patient has a specific cardiac condition that interacts with the laxative. Choice C (Several hemorrhoids) and Choice D (Chronic constipation) are not contraindications for administering an oral laxative.

3. A client has metoprolol prescribed. The nurse should reinforce instructions that this medication has which potential adverse effect?

• A. Anxiety
• B. Tachycardia
• C. Sexual dysfunction
• D. Acute renal failure

Correct answer: C

Rationale: The correct answer is C: Sexual dysfunction. Metoprolol, a beta-blocker, can cause sexual dysfunction as an adverse effect. It is important for the nurse to educate the client about this potential side effect. Choice A is incorrect because metoprolol can cause depression, not anxiety. Choice B is incorrect as tachycardia is not an adverse effect of metoprolol; instead, it can lead to bradycardia. Choice D is incorrect because acute renal failure is not typically associated with the use of beta-blockers.

4. A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?

• A. I will take one tablet every 5 minutes, up to three tablets.
• B. I should take one tablet at the onset of angina and stop activity.
• C. I need to replace nitroglycerin tablets every 3 to 6 months to maintain freshness.
• D. I should ensure that I chew the pill completely before swallowing it.

Correct answer: D

Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.

5. A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer the requested medication, the client is seen talking and laughing with visiting family. What action should the PN take?

• A. Hold the pain medication until after the visitors leave.
• B. Notify the healthcare provider of the client's drug-seeking behavior.
• C. Administer analgesia as requested by the client.
• D. Inform the client that the medication is not needed based on their behavior.

Correct answer: C

Rationale: The correct action for the PN in this situation is to administer the analgesia as requested by the client. Pain management is based on the client's self-report of pain, which is the most reliable indicator of pain intensity. Analgesics should be given promptly when pain occurs and before it worsens. Following the administration of medication, the PN should discuss the situation with the charge nurse for further guidance or assessment.

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