Nursing Elites

1. Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history?

• A. Gout
• B. Asthma
• C. Thrombophlebitis
• D. Myocardial infarction

Correct answer: C

Rationale: Megestrol acetate can increase the risk of thromboembolic events. Clients with a history of thrombophlebitis should not receive this medication due to the increased risk of thromboembolic events. Therefore, the nurse should contact the registered nurse if thrombophlebitis is documented in the client's history to ensure appropriate medication management.

2. A client is taking cetirizine hydrochloride (Zyrtec). The nurse checks for which of the following side effects of this medication?

• A. Diarrhea
• B. Excitability
• C. Drowsiness
• D. Excess salivation

Correct answer: C

Rationale: Cetirizine hydrochloride (Zyrtec) is known to commonly cause drowsiness or sedation as a side effect. Therefore, the nurse should monitor the client for signs of drowsiness when administering this medication. Choice A, Diarrhea, is not a common side effect of cetirizine. Choice B, Excitability, is not a typical side effect of this antihistamine; instead, it tends to cause drowsiness. Choice D, Excess salivation, is not associated with cetirizine use.

3. A client is being monitored while receiving bethanechol chloride (Urecholine) for urinary retention. Which of the following indicates a therapeutic effect of this medication?

• A. Increased heart rate
• B. Increased peristalsis
• C. Passage of flatus
• D. Urinary output of 50 mL per hour

Correct answer: D

Rationale: Bethanechol chloride (Urecholine) is administered to stimulate the bladder and treat urinary retention. The therapeutic effect is indicated by an increased urinary output, as it demonstrates the medication's ability to prompt the bladder to empty. Increased heart rate and passage of flatus are unrelated to the therapeutic effects of bethanechol. Although bethanechol can increase peristalsis, the primary therapeutic goal is to address urinary retention.

4. A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?

• A. Apply the patch to a hairless area of skin.
• B. Leave the patch on for 24 hours.
• C. Apply the patch at the same time each day.
• D. You can keep the patch on while taking a shower.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching plan is to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day. This consistency helps maintain steady blood levels of the medication. While it is important to apply the patch to a hairless area of the skin for proper absorption, it does not necessarily have to be left on for 24 hours; typically, it is worn for 12-14 hours to allow for a nitrate-free period and reduce tolerance. Additionally, the patch can generally be kept on while taking a shower, as water exposure does not typically affect its efficacy.

5. The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?

• A. Weight loss
• B. Relief of heartburn
• C. Reduction of steatorrhea
• D. Absence of abdominal pain

Correct answer: C

Rationale: Pancrelipase (Pancrease MT) is a pancreatic enzyme replacement therapy used to aid digestion in clients with pancreatic insufficiency. One of the key goals of pancrelipase therapy is to reduce the amount of undigested fat in the stool, known as steatorrhea. Therefore, the nurse should evaluate the effectiveness of pancrelipase by looking for a reduction in steatorrhea, indicating improved digestion and absorption of fats.

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