Nursing Elites

1. A client with heart failure is being instructed on laxative use. Which of the following laxatives should the client avoid?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: The correct answer is A: Sodium phosphate. Clients with heart failure often follow a sodium-restricted diet. Sodium phosphate laxatives can lead to sodium absorption, causing fluid retention, which is contraindicated in heart failure. It is crucial to avoid sodium phosphate laxatives in these clients to prevent exacerbation of fluid overload and heart failure symptoms. Psyllium (choice B), Bisacodyl (choice C), and Polyethylene glycol (choice D) are not contraindicated in clients with heart failure and can be used safely for bowel management.

2. A client has a new prescription for Oxycodone/Acetaminophen. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking additional Acetaminophen while on Oxycodone/Acetaminophen. This is important to prevent exceeding the maximum recommended dose and reducing the risk of liver toxicity. Oxycodone/Acetaminophen already contains Acetaminophen, so additional intake can lead to an overdose of this component. Choices A, C, and D are incorrect. Taking the medication on an empty stomach or increasing fiber intake are not specific instructions related to this medication. Avoiding taking the medication before bedtime is not directly relevant to the combination of Oxycodone/Acetaminophen.

3. A client has a new prescription for colchicine to treat gout. Which of the following instructions should be included?

• A. Take this medication with food if nausea develops.
• B. Monitor for muscle pain.
• C. Expect to have increased bruising.
• D. Increase your intake of grapefruit juice.

Correct answer: B

Rationale: Monitoring for muscle pain is crucial when taking colchicine because it can lead to rhabdomyolysis, a serious condition characterized by muscle breakdown. This adverse effect needs prompt identification to prevent complications. Choices A, C, and D are incorrect because taking colchicine with food, experiencing increased bruising, or increasing grapefruit juice intake are not relevant instructions for a client prescribed colchicine for gout.

4. When starting therapy with cisplatin, a client should report which of the following adverse effects as instructed by the nurse?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The nurse should instruct the client to report tinnitus because it can be an indication of ototoxicity, a potential adverse effect of cisplatin. Ototoxicity can manifest as tinnitus, hearing loss, or balance disturbances, so it is crucial for the client to promptly report any changes in hearing such as tinnitus to prevent further damage.

5. A hospitalized client has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should be prepared for transfusion?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the appropriate blood product for a client with an elevated aPTT as it contains various coagulation factors that can help correct coagulopathies and prevent bleeding. Elevated aPTT indicates a deficiency in specific clotting factors, and fresh frozen plasma is rich in these factors. Whole blood, platelets, and packed red blood cells do not contain the necessary coagulation factors to correct an elevated aPTT, so they are not indicated in this situation.

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