Nursing Elites

1. A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for:

• A. Pupillary changes
• B. Scattered lung wheezes
• C. Sudden increase in pain
• D. Sudden episodes of diarrhea

Correct answer: C

Rationale: Naloxone hydrochloride is an antidote to opioids and may be administered to postoperative clients to address respiratory depression. This medication can also reverse the effects of analgesics, potentially leading to a sudden increase in pain. Therefore, the nurse must assess the client for any unexpected rise in pain levels after naloxone administration. Choices A, B, and D are incorrect because pupillary changes, scattered lung wheezes, and sudden episodes of diarrhea are not typically associated with naloxone administration for respiratory depression.

2. When a client is taking lansoprazole (Prevacid), which question should the nurse ask during data collection to determine medication effectiveness?

• A. Has your appetite increased?
• B. Are you experiencing any heartburn?
• C. Do you have any problems with vision?
• D. Do you experience any leg pain when walking?

Correct answer: B

Rationale: When a client is taking lansoprazole (Prevacid), a gastric acid pump inhibitor used to treat gastroesophageal reflux disease (GERD), the nurse should ask if the client is experiencing any heartburn to determine medication effectiveness. Heartburn is a common symptom of GERD, and the reduction of heartburn indicates the effectiveness of lansoprazole in managing acid reflux symptoms. Choices A, C, and D are not relevant to assessing the effectiveness of lansoprazole for GERD.

3. A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select one that doesn't apply.

• A. Nizatidine (Axid)
• B. Ranitidine (Zantac)
• C. Famotidine (Pepcid)
• D. Ibuprofen (Motrin)

Correct answer: D

Rationale: H2-receptor antagonists like Nizatidine, Ranitidine, and Famotidine are used to suppress gastric acid secretion, relieve heartburn symptoms, and prevent complications of peptic ulcer disease. Ibuprofen, on the other hand, is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, but it is not an H2-receptor antagonist. It is essential to differentiate between these medication classes to ensure appropriate treatment for gastrointestinal conditions.

4. Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?

• A. Listen to the client's lung sounds.
• B. Check the client's blood pressure.
• C. Check the recent electrolyte levels.
• D. Assess the client for muscle weakness.

Correct answer: B

Rationale: Atenolol hydrochloride is a beta-blocker used to treat hypertension. Checking the client's blood pressure is crucial before administration.

5. The client has reinforced instructions for taking cholestyramine (Questran). Which statement indicates a need for further instructions?

• A. I will continue taking vitamin supplements.
• B. This medication will help lower my cholesterol.
• C. This medication should only be taken with water.
• D. A high-fiber diet is important while taking this medication.

Correct answer: C

Rationale: The correct answer is C because cholestyramine should not only be taken with water. Flavored products or fruit juices can improve the taste. Choices A, B, and D are all correct statements. It is important for the client to continue taking vitamin supplements, understand that cholestyramine helps lower cholesterol, and maintain a high-fiber diet while taking this medication to enhance its effectiveness.

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