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 healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause a non-productive cough due to its effect on bradykinin levels. The client should be advised to report this symptom to their healthcare provider to consider alternative treatments. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not typically associated with Enalapril use.

3. Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?

• A. 45 minutes to 18 hours
• B. 30 minutes to 12 hours
• C. 90 minutes to 36 hours
• D. 60 minutes to 24 hours

Correct answer: B

Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.

4. What is the antidote for Heparin?

• A. Protamine sulfate
• B. Vitamin K
• C. Naloxone
• D. Toradol

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant that prevents blood clotting. Protamine sulfate is the antidote for Heparin as it binds to heparin, neutralizing its anticoagulant effects. Vitamin K is not the antidote for Heparin; it is used to reverse the effects of warfarin, another anticoagulant. Naloxone is an opioid antagonist for opioids, and Toradol is a nonsteroidal anti-inflammatory drug (NSAID) for pain relief. Therefore, the correct antidote for Heparin is Protamine sulfate.

5. A client has a new prescription for Dabigatran. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Store the capsules in a pill organizer.
• C. Crush the medication before swallowing.
• D. Expect frequent headaches while taking this medication.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with food.' Taking Dabigatran with food is recommended to reduce gastrointestinal discomfort, a common side effect associated with this medication. Food can help minimize stomach irritation and improve tolerability. Choices B, C, and D are incorrect. Storing the capsules in a pill organizer (B) is a good practice for organization but not a specific instruction for this medication. Crushing the medication before swallowing (C) is not recommended for Dabigatran as it is available as a capsule and should be swallowed whole. Expecting frequent headaches while taking this medication (D) is not a common side effect of Dabigatran and should not be anticipated.

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