Nursing Elites

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

• A. Take this medication with food.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Increase your intake of sodium-rich foods.

Correct answer: C

Rationale: Captopril should be taken on an empty stomach for better absorption. The client should be instructed to take it 1 hour before or 2 hours after meals to optimize its effectiveness. Taking it with food can reduce its absorption and efficacy.

2. A client has a new prescription for Warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, not potassium. Therefore, the client needs to be cautious with foods high in vitamin K, such as green leafy vegetables, rather than foods high in potassium. Choices A, B, and D are correct statements regarding Warfarin therapy and do not indicate a need for further teaching.

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

• 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 instruction for a client with a prescription for Oxycodone/Acetaminophen is to avoid taking additional Acetaminophen while on this medication. Combining medications containing Acetaminophen can lead to exceeding the maximum recommended dose and increase the risk of liver toxicity. Therefore, it is crucial for the nurse to emphasize the importance of not taking extra Acetaminophen while on this prescription to ensure the client's safety and well-being. Choices A, C, and D are incorrect. Taking Oxycodone/Acetaminophen on an empty stomach is not necessary; increasing fiber intake is not directly related to this medication, and avoiding taking the medication before bedtime is not a specific concern associated with this prescription.

4. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots forming and leading to serious complications like pulmonary embolism. Clients with a history of deep-vein thrombosis are at a higher risk of recurrent thromboembolic events when taking tamoxifen, making it unsafe for such individuals. Choices B, C, and D are not contraindications for tamoxifen therapy, as migraine headaches, hypertension, and anemia do not directly interact with tamoxifen's mechanism of action or pose significant risks when used together.

5. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?

• A. Stop the infusion.
• B. Call the provider.
• C. Elevate the head of the bed.
• D. Auscultate breath sounds.

Correct answer: A

Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.

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