Nursing Elites

1. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.

2. A client has a new prescription for Levothyroxine to treat hypothyroidism. Which of the following instructions should be included in the teaching?

• A. Take this medication with food.
• B. Take this medication at bedtime.
• C. Expect to see results in 1 week.
• D. Do not discontinue the medication without consulting the provider.

Correct answer: D

Rationale: The correct instruction for a client with a new prescription for Levothyroxine to treat hypothyroidism is not to discontinue the medication without consulting the provider. Abrupt cessation could lead to the return of hypothyroid symptoms, emphasizing the importance of medical guidance when considering any changes to the treatment plan. Choice A is incorrect because Levothyroxine should be taken on an empty stomach, typically in the morning. Choice B is incorrect as it contradicts the timing of administration for Levothyroxine. Choice C is inaccurate as it usually takes a few weeks for the full effects of Levothyroxine to be seen, not just 1 week.

3. A client has a prescription for Nitroglycerin. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin involves taking one tablet at the onset of chest pain, then another tablet every 5 minutes for up to three doses. This protocol aims to relieve angina symptoms. Choice A is incorrect because waiting 15 minutes between doses may delay symptom relief. Choice C is incorrect as Nitroglycerin is not typically taken at bedtime but rather during angina episodes. Choice D is incorrect because Nitroglycerin is usually taken sublingually, so it doesn't need to be taken on an empty stomach.

4. A client with Graves' disease is being educated by a nurse about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heartbeat.
• D. Propranolol promotes a decrease of thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that is commonly used in Graves' disease to decrease symptoms such as tremors and fast heart rate. Choice A is incorrect because Propranolol does not increase blood flow to the thyroid gland. Choice B is incorrect as Propranolol is not used to prevent excess glucose in the blood. Choice D is also incorrect as Propranolol does not directly decrease thyroid hormone levels in the body.

5. A client has a new prescription for Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the following adverse reactions?

• A. Bone marrow suppression
• B. Pancreatitis
• C. Pancreatitis
• D. Bone marrow suppression

Correct answer: D

Rationale: While bone marrow suppression is not typically associated with Enfuvirtide, a more relevant concern is the risk of severe allergic reactions such as anaphylaxis. Enfuvirtide, an HIV fusion inhibitor, can cause local injection site reactions and systemic allergic responses. Monitoring for signs of allergic reactions, such as rash, fever, and difficulty breathing, is crucial to ensure the client's safety.

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