Nursing Elites

1. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication on an empty stomach.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.

2. What is the pharmacological action of metformin?

• A. Blocks stimulation of beta1 and beta2.
• B. Blocks vasoconstriction and aldosterone.
• C. Acts at many levels in the CNS to produce an anxiolytic effect.
• D. Decreases hepatic glucose production.

Correct answer: D

Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.

3. A client has a new prescription for Valsartan, and a nurse is providing discharge teaching. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid potassium-rich foods.
• C. Expect to feel drowsy.
• D. Monitor your blood pressure daily.

Correct answer: D

Rationale: Monitoring blood pressure daily is crucial for clients taking Valsartan, an angiotensin II receptor blocker, to ensure effective management of hypertension. Valsartan helps lower blood pressure by relaxing blood vessels, and regular monitoring helps track the medication's effectiveness and any potential side effects. Choices A, B, and C are incorrect because Valsartan does not need to be taken with food, avoiding potassium-rich foods is not specifically required for this medication, and feeling drowsy is not a common side effect of Valsartan.

4. While caring for a client taking Propylthiouracil, for which of the following adverse effects should the nurse monitor?

• A. Bradycardia
• B. Insomnia
• C. Heat intolerance
• D. Weight loss

Correct answer: A

Rationale: When a client is taking Propylthiouracil, the nurse should monitor for bradycardia as it is an adverse effect of this medication. Propylthiouracil can lead to a decrease in heart rate, which is known as bradycardia. Monitoring for this adverse effect is crucial to ensure the client's safety and well-being while on this medication. The other options, such as insomnia, heat intolerance, and weight loss, are not commonly associated adverse effects of Propylthiouracil. Therefore, they are incorrect choices for monitoring while the client is on this medication.

5. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?

• A. Use a blood pressure cuff to distend the veins.
• B. Select the antecubital area to insert the IV catheter.
• C. Distend the veins by using a blood pressure cuff.
• D. Direct the client to lower his arm below his heart.

Correct answer: C

Rationale: The correct answer is C. The healthcare professional should distend the veins using a blood pressure cuff to make the veins more visible and accessible for IV catheter insertion. This technique helps reduce the risk of overfilling the vein, which can lead to complications such as hematoma formation. Choices A, B, and D are incorrect because while selecting the antecubital area is often appropriate for IV insertion in adults, the key action in this scenario is to distend the veins using a blood pressure cuff to facilitate the procedure.

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