Nursing Elites

1. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following foods should the provider instruct the client to avoid?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients taking Warfarin should avoid foods high in vitamin K, such as broccoli, as they can interfere with the effectiveness of the medication. Vitamin K can counteract the anticoagulant effects of Warfarin, potentially leading to blood clotting issues. Broccoli is rich in vitamin K, so its consumption should be consistent to avoid fluctuations in the medication's effectiveness. Bananas, chicken, and potatoes are not known to significantly interact with Warfarin and do not pose a risk of affecting its anticoagulant properties.

2. A healthcare professional is preparing to administer Enoxaparin to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication orally.
• B. Massage the injection site after administration.
• C. Insert the needle at a 45- to 90-degree angle.
• D. Aspirate before injecting the medication.

Correct answer: C

Rationale: Enoxaparin should be administered subcutaneously at a 45- to 90-degree angle. This angle ensures proper delivery of the medication. Massaging the injection site should be avoided to prevent bruising and possible tissue damage. Aspiration is not required for subcutaneous injections like Enoxaparin. Therefore, the correct action for administering Enoxaparin is to insert the needle at a 45- to 90-degree angle.

3. When administering IV Amphotericin B to a client with a systemic fungal infection, the nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypoglycemia
• B. Constipation
• C. Fever
• D. Hyperkalemia

Correct answer: C

Rationale: The correct answer is fever. Amphotericin B is known to cause adverse effects such as fever, chills, and nausea during infusion. Monitoring for fever is essential as it can indicate an adverse reaction. To manage these effects, pretreatment with diphenhydramine and acetaminophen can be administered.

4. A client who has been taking prednisone to treat asthma is advised to discontinue the medication. The client should be instructed to reduce the dose gradually to prevent which of the following adverse effects?

• A. Hyperglycemia
• B. Adrenocortical insufficiency
• C. Severe dehydration
• D. Rebound pulmonary congestion

Correct answer: B

Rationale: Abruptly stopping prednisone can result in adrenocortical insufficiency due to suppression of the adrenal glands. Gradually tapering the dose helps the body adjust and resume its natural cortisol production, preventing adrenal insufficiency. Choice A, hyperglycemia, is a possible adverse effect of prednisone, but it is not the primary reason for gradual tapering. Severe dehydration (Choice C) and rebound pulmonary congestion (Choice D) are not typically associated with discontinuing prednisone.

5. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

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