Nursing Elites

1. Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history, knowing that this medication is contraindicated if which of the following disorders is present?

• A. Headaches
• B. Liver disease
• C. Hypothyroidism
• D. Diabetes mellitus

Correct answer: B

Rationale: Carbamazepine (Tegretol) is contraindicated in liver disease due to its potential to cause hepatic toxicity. Regular monitoring of liver function tests is necessary when using this medication to detect any signs of liver damage.

2. A client has been prescribed furosemide (Lasix), and the nurse is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect? Select one that doesn't apply.

• A. Nausea
• B. Tinnitus
• C. Hypotension
• D. Hypokalemia

Correct answer: A

Rationale: Furosemide is a loop diuretic that can lead to adverse effects such as tinnitus, hypotension, and hypokalemia. While nausea is a common side effect of many medications, it is not typically associated with furosemide. Therefore, the nurse should recognize nausea as a potential adverse effect that doesn't apply to furosemide.

3. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:

• A. Should always be taken with food or antacids
• B. Should be double-dosed if one dose is forgotten
• C. Causes orange discoloration of sweat, tears, urine, and feces
• D. May not be discontinued independently if symptoms are gone in 3 months

Correct answer: C

Rationale: Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.

4. When providing instructions to a client taking ciprofloxacin (Cipro), which of the following should the nurse include in the teaching plan?

• A. Avoid taking the medication with milk or antacids.
• B. Take the medication with a multivitamin.
• C. Consume extra dairy products while taking this medication.
• D. Take the medication with food if gastrointestinal upset occurs.

Correct answer: A

Rationale: The correct answer is to avoid taking ciprofloxacin (Cipro) with milk or antacids. These can interfere with the medication's absorption. Consuming extra dairy products or taking it with a multivitamin is not recommended for the same reason. If gastrointestinal upset occurs, the medication can be taken with food to help alleviate the symptoms.

5. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

• A. Fever
• B. Diarrhea
• C. Complaints of nausea and vomiting
• D. Crackles on auscultation of the lungs

Correct answer: D

Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.

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