Nursing Elites

1. A healthcare provider is completing a client's medical history. The client takes Simvastatin. The healthcare provider should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in patients with active moderate-to-severe liver disorders, such as active hepatitis C, especially when they are already taking a statin like simvastatin. This combination can increase the risk of liver problems and is not recommended due to the potential for further liver damage. Choices A, B, and D are not directly contraindications for adding Ezetimibe to the client's medications.

2. A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?

• A. Reflex tachycardia
• B. Dizziness
• C. Hyponatremia
• D. Hypotension

Correct answer: C

Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.

3. A healthcare professional is caring for a group of clients receiving antimicrobial therapy. Which of the following clients should the professional plan to monitor for manifestations of antibiotic toxicity?

• A. An adolescent client with a sinus infection
• B. An older adult client with prostatitis
• C. A client who is postpartum with mastitis
• D. A middle-aged client with a urinary tract infection

Correct answer: B

Rationale: An older adult client with prostatitis who is receiving antibiotics should be monitored for toxicity due to age-related reductions in medication metabolism and excretion. Older adults are more susceptible to antibiotic toxicity, making them a high-risk group for adverse effects.

4. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Remove the nitroglycerin patch for 30 minutes if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each evening to prevent tolerance. This allows for a nitrate-free period of 10 to 12 hours during each 24-hour period, reducing the risk of developing tolerance to the medication. Choice B is incorrect because cutting the patch could alter the dose delivery and is not recommended. Choice C is incorrect as removing the patch for 30 minutes when a headache occurs may not be effective in managing symptoms. Choice D is incorrect as Nitroglycerin patches are usually applied once daily, not every 48 hours.

5. A client has a new prescription for Loperamide. Which of the following instructions should the nurse include?

• A. Take the medication with a full glass of water.
• B. Avoid activities that require alertness.
• C. Increase your intake of high-fiber foods.
• D. Expect your stools to be black and tarry.

Correct answer: B

Rationale: The correct answer is B. Loperamide can cause drowsiness and dizziness, so clients should avoid activities that require alertness until they know how the medication affects them. Taking the medication with a full glass of water can help with absorption. Increasing intake of high-fiber foods is not directly related to Loperamide. Black, tarry stools are not expected side effects of this medication, so informing the client to expect this is incorrect.

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