Nursing Elites

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

• A. Apply the patch to a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to remove it each day, usually at bedtime, to prevent tolerance. Keeping the patch on for 24 hours at a time can lead to tolerance development. Applying the patch to a different site each day is not necessary, as long as the area is rotated to prevent skin irritation. Applying the patch over an area with little or no hair is not a critical instruction for the Nitroglycerin patch.

2. How is lithium typically administered?

• A. Intravenously
• B. Intramuscularly
• C. Orally
• D. Sublingually

Correct answer: C

Rationale: Lithium is typically administered orally to ensure proper absorption and distribution in the body. By taking lithium orally, it allows the medication to be absorbed through the gastrointestinal tract and distributed effectively. Intravenous and intramuscular routes are not commonly used for lithium administration as they can lead to rapid, unpredictable absorption and increase the risk of toxicity. Sublingual administration is also not the typical route for lithium, as it is usually taken orally for consistent and controlled absorption.

3. A client has a new prescription for metronidazole. The client should avoid which of the following?

• A. Dairy products
• B. Alcohol
• C. Leafy green vegetables
• D. Grapefruit juice

Correct answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole to prevent a disulfiram-like reaction, which can cause symptoms such as nausea, vomiting, headache, and flushing. Alcohol can interact with metronidazole and lead to adverse effects. Choices A, C, and D are not typically contraindicated with metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole, unlike alcohol.

4. A client is starting Simvastatin. Which of the following information should be included in the teaching?

• A. Take this medication in the evening.
• B. Change positions slowly when rising from a chair.
• C. Maintain a steady intake of green leafy vegetables.
• D. Consume no more than 1 L/day of fluid.

Correct answer: A

Rationale: The correct answer is to take simvastatin in the evening. This timing is recommended because nighttime is when the most cholesterol is synthesized in the body. By taking statin medications in the evening, it can enhance their effectiveness in reducing cholesterol levels.

5. A healthcare provider is reviewing a client's health record and notes that the client is experiencing episodes of hypokalemia. Which of the following medications should the healthcare provider identify as a cause of the client's hypokalemia?

• A. Captopril
• B. Lisinopril
• C. Furosemide
• D. Spironolactone

Correct answer: C

Rationale: Furosemide is a loop diuretic that acts on the kidneys to increase urine production. This increased urine output can lead to the excessive excretion of potassium, resulting in hypokalemia. Monitoring potassium levels and considering supplementation may be necessary when a patient is on furosemide to prevent or manage hypokalemia.

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