Nursing Elites

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

• A. Avoid drinking grapefruit juice.
• B. Take the medication with your evening meal.
• C. Increase your intake of leafy green vegetables.
• D. Stop taking the medication if you experience muscle pain.

Correct answer: A

Rationale: The correct answer is A: 'Avoid drinking grapefruit juice.' Grapefruit juice should be avoided when taking Atorvastatin because it can increase the blood levels of the medication, potentially leading to a higher risk of adverse effects like muscle pain and liver damage. It is important to follow this instruction to ensure the safe and effective use of Atorvastatin. Choices B, C, and D are incorrect. Taking Atorvastatin with food, specifically a low-fat meal, is recommended, but it is not necessary to specify the evening meal. While increasing intake of leafy green vegetables is generally beneficial for health, it is not a specific instruction for Atorvastatin. Lastly, stopping the medication if one experiences muscle pain is not advisable without consulting a healthcare provider, as muscle pain can be a symptom of a serious side effect of Atorvastatin that requires medical attention.

2. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

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

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect decreased urination within the first few days.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Hydrochlorothiazide is a diuretic that can lead to hypokalemia by increasing potassium excretion. Therefore, instructing the client to increase their intake of potassium-rich foods is essential to prevent electrolyte imbalances and support overall health. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning is not directly related to the medication's mechanism of action. Expecting decreased urination within the first few days is not accurate as the medication is a diuretic that typically increases urination. Also, advising the client to avoid foods high in potassium would not be suitable, as increasing potassium-rich foods is necessary to counteract potential potassium depletion caused by Hydrochlorothiazide.

4. To which pharmacologic classification does the drug propranolol belong?

• A. Beta Blockers
• B. Cholinergics
• C. Immune globulins
• D. Barbiturates

Correct answer: A

Rationale: Propranolol belongs to the pharmacologic classification of Beta Blockers. Beta blockers work by blocking the action of adrenaline and other stress hormones on beta-adrenergic receptors. They are commonly used to manage conditions like high blood pressure, angina, and arrhythmias. Choice B, Cholinergics, is incorrect because cholinergics work by stimulating the parasympathetic nervous system, unlike beta blockers that block adrenergic receptors. Choice C, Immune globulins, is incorrect as it refers to antibodies used to boost the immune system, not the mechanism of action of propranolol. Choice D, Barbiturates, is incorrect as barbiturates are a different class of drugs that act as central nervous system depressants, primarily used as sedatives and anesthetics.

5. Which of the following conditions is not treated with Dexamethasone?

• A. Inflammation
• B. Asthma
• C. Addison’s disease
• D. Wilson’s disease

Correct answer: D

Rationale: Dexamethasone is not used to treat Wilson’s disease. It is a corticosteroid primarily used for conditions like inflammation, asthma, and Addison’s disease. Wilson’s disease is a genetic disorder involving copper accumulation and is treated with medications like chelating agents or zinc salts, not Dexamethasone.

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