Nursing Elites

1. 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.

2. A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:

• A. Avoid drinking alcohol.
• B. Report yellow eyes or skin immediately.
• C. Avoid Swiss or aged cheeses.
• D. Avoid vitamin supplements during therapy.

Correct answer: B

Rationale: When a client is on isoniazid (INH) therapy, they should be instructed to report any signs of hepatitis, such as yellowing of the eyes or skin, immediately. Alcohol consumption should be avoided during INH therapy due to the risk of hepatotoxicity. Foods high in tyramine, such as Swiss or aged cheeses, should also be avoided to prevent adverse reactions. Additionally, while on INH therapy, it is essential to avoid vitamin supplements containing pyridoxine (vitamin B6) to prevent potential interactions.

3. Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?

• A. Gastric atony
• B. Urinary strictures
• C. Neurogenic atony
• D. Gastroesophageal reflux

Correct answer: B

Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications. Gastric atony, neurogenic atony, and gastroesophageal reflux are not contraindications for the administration of Bethanechol chloride for urinary retention.

4. The clinic nurse is reviewing a teaching plan for a client receiving antineoplastic medication. When implementing the plan, the nurse should advise the client:

• A. To take aspirin (acetylsalicylic acid) as needed for a headache
• B. To avoid drinking beverages containing alcohol
• C. To consult with healthcare providers (HCPs) before receiving immunizations
• D. That it is necessary to consult HCPs before receiving a flu vaccine at the local health fair

Correct answer: C

Rationale: The correct advice for a client receiving antineoplastic medication is to consult with healthcare providers (HCPs) before receiving immunizations. Antineoplastic medications can lower the body's resistance, making it crucial to seek guidance from healthcare providers to prevent potential complications that may arise due to the medication's impact on the immune system. Choices A, B, and D are incorrect because taking aspirin for a headache, avoiding alcohol, and consulting only before a flu vaccine at a local health fair do not directly address the specific risk related to antineoplastic medications and immunizations.

5. When monitoring a client for acute toxicity associated with bethanechol chloride (Urecholine), what sign should the nurse check for to indicate toxicity?

• A. Dry skin
• B. Dry mouth
• C. Bradycardia
• D. Signs of dehydration

Correct answer: C

Rationale: The correct answer is C: Bradycardia. Toxicity from bethanechol chloride (Urecholine) can lead to excessive muscarinic stimulation, resulting in manifestations like salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. When facing toxicity, treatment involves supportive measures and administering atropine sulfate subcutaneously or intravenously.

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