Nursing Elites

1. A practical nurse (PN) is reviewing teaching with the client and/or significant others about the concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should the PN reinforce?

• A. Benztropine will reduce olanzapine's side effect of urinary retention.
• B. Benztropine potentiates the effect of olanzapine.
• C. Benztropine is used to control the side effects of olanzapine.
• D. The combined effect of these drugs will modify psychotic behavior.

Correct answer: C

Rationale: The correct answer is C because benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with olanzapine use. Choice A is incorrect because benztropine does not directly reduce olanzapine's side effect of urinary retention. Choice B is incorrect as benztropine does not potentiate the effect of olanzapine; its main role is to counteract extrapyramidal symptoms. Choice D is incorrect because the primary purpose of using benztropine alongside olanzapine is to manage side effects, not specifically to modify psychotic behavior.

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 with diabetes mellitus type 2 is prescribed dapagliflozin. The nurse should monitor for which potential adverse effect?

• A. Genital infections
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Genital infections. Dapagliflozin, a medication used in diabetes mellitus type 2, is associated with an increased risk of genital infections. Its mechanism of action involves promoting glucose excretion through the urine, creating a favorable environment for microbial growth in the genital area. Monitoring for genital infections is crucial when a client is prescribed dapagliflozin. Hypoglycemia (choice B) is not a common adverse effect of dapagliflozin since it does not directly lower blood glucose levels. Hyperglycemia (choice C) is also unlikely as dapagliflozin is intended to help lower blood glucose levels. Nausea (choice D) is a less common side effect of dapagliflozin compared to genital infections.

4. The healthcare professional is creating a class for older adults in the community. Which information about laxative use in older adults would be important to include?

• A. Laxatives are not effective in older adults
• B. All laxatives are exactly the same
• C. Over-the-counter laxatives are misused
• D. Laxatives can cause potassium retention

Correct answer: C

Rationale: It is important to include information about the misuse of over-the-counter laxatives in older adults as they often misuse these medications, which can lead to dependency and other health issues. Option A is incorrect as laxatives can be effective in older adults when used appropriately. Option B is incorrect because not all laxatives are the same, they have different mechanisms of action and side effects. Option D is incorrect because laxatives can actually cause electrolyte imbalances like potassium depletion rather than retention.

5. A client with a history of atrial fibrillation is prescribed diltiazem. The nurse should monitor for which potential side effect?

• A. Hypotension
• B. Tachycardia
• C. Headache
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Hypotension. Diltiazem is a calcium channel blocker that can cause hypotension by relaxing blood vessels and reducing blood pressure. Monitoring blood pressure is essential to detect and manage this potential side effect. Choices B, C, and D are incorrect because diltiazem typically does not cause tachycardia, headache, or hyperglycemia as common side effects.

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