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 with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?

• A. Echocardiography
• B. Electrocardiography
• C. Cervical radiography
• D. Pulmonary function studies

Correct answer: D

Rationale: Bleomycin, when administered intravenously, can lead to interstitial pneumonitis and potentially progress to pulmonary fibrosis. Therefore, pulmonary function studies are essential to monitor lung function and detect any early signs of pulmonary toxicity. Other tests, such as regular pulmonary assessments, should also be conducted to ensure the safety and well-being of the client.

3. Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?

• A. Pallor
• B. Drowsiness
• C. Bradycardia
• D. Restlessness

Correct answer: D

Rationale: Signs of toxicity related to oxybutynin chloride (Ditropan XL) include central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity may include hypotension or hypertension, confusion, tachycardia, a flushed or red face, and signs of respiratory depression. Restlessness is a sign of central nervous system excitation, which can indicate a possible toxic effect of this medication.

4. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

• A. Tinnitus
• B. Diarrhea
• C. Constipation
• D. Decreased respirations

Correct answer: A

Rationale: The correct answer is A: Tinnitus. Salicylic acid can lead to systemic toxicity, known as salicylism, which may manifest with symptoms like tinnitus, dizziness, hyperventilation, and mental disturbances. Tinnitus is a common early sign of salicylism and should be monitored closely by the nurse to prevent further complications.

5. The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?

• A. Resolved diarrhea
• B. Relief of epigastric pain
• C. Decreased platelet count
• D. Decreased white blood cell count

Correct answer: B

Rationale: Misoprostol is a gastric protectant administered to clients using NSAIDs to prevent gastric mucosal injury. Relief of epigastric pain signifies the medication's therapeutic effect as it indicates a reduction in gastrointestinal symptoms associated with NSAID use.

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