Nursing Elites

1. The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

• A. Diarrhea
• B. Heartburn
• C. Flatulence
• D. Constipation

Correct answer: B

Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.

2. 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.

3. 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.

4. Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?

• A. To take the medication after meals
• B. To return to the clinic weekly for serum drug-level testing
• C. To call the health care provider (HCP) if a skin rash occurs
• D. To restrict alcohol intake with this medication

Correct answer: B

Rationale: Cycloserine requires weekly serum drug level determinations to monitor for neurotoxicity. The medication must be taken after meals, and the client should avoid alcohol. Additionally, the client should report any signs of skin rash or central nervous system toxicity to the healthcare provider.

5. When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?

• A. Assessing the injection site for itching and edema
• B. Monitoring white blood cell counts and platelet counts
• C. Evaluating for fatigue and joint pain in the client
• D. Checking for a metallic taste in the mouth and loss of appetite

Correct answer: B

Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.

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