Nursing Elites

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

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.

2. A client has been prescribed Atorvastatin to lower cholesterol. Which of the following instructions should the nurse include?

• A. Take this medication with a full glass of water.
• B. Report any muscle pain to your provider immediately.
• C. Avoid drinking grapefruit juice while taking this medication.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to 'Report any muscle pain to your provider immediately.' Muscle pain can be a sign of rhabdomyolysis, a rare but serious side effect of statins like atorvastatin. It is crucial to monitor for potential complications, and reporting muscle pain promptly can lead to timely intervention if needed. Choices A, C, and D are incorrect because they do not address a critical side effect of atorvastatin or provide essential information for the client's safety and well-being.

3. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. It is essential to alternate nostrils daily when inhaling the medication to ensure equal distribution and optimal absorption. This technique helps prevent irritation and congestion in one nostril and enhances the effectiveness of the medication. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed, applied topically, or taken as a liquid medication after meals. Therefore, instructing the client to alternate nostrils during inhalation is the most appropriate teaching for this medication.

4. A healthcare provider is assessing a client who takes Desmopressin for Diabetes Insipidus. For which of the following adverse effects should the healthcare provider monitor?

• A. Hypovolemia
• B. Hypercalcemia
• C. Agitation
• D. Headache

Correct answer: D

Rationale: The correct answer is D: Headache. Headache during desmopressin therapy can indicate water intoxication, which is a potential adverse effect. Desmopressin is a medication used to treat Diabetes Insipidus by reducing excessive urination and thirst. Monitoring for headaches is crucial as it can signal decreased sodium levels due to water retention, leading to water intoxication, which is a serious concern. Hypovolemia, hypercalcemia, and agitation are not typically associated with desmopressin therapy for Diabetes Insipidus.

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

• A. Take the medication with food.
• B. Expect your urine to turn dark yellow.
• C. Take the medication with a full glass of milk.
• D. Report persistent diarrhea to your provider.

Correct answer: D

Rationale: The correct answer is D: 'Report persistent diarrhea to your provider.' Erythromycin is known to cause Clostridium difficile-associated diarrhea, which can be severe. Instructing the client to report any persistent diarrhea to their healthcare provider promptly is crucial to prevent complications. Choices A, B, and C are incorrect. Taking Erythromycin with food is generally recommended to reduce stomach upset, but it is not the most critical instruction. Expecting urine to turn dark yellow is not a common side effect of Erythromycin. Taking Erythromycin with a full glass of milk is not necessary and may not be appropriate for all clients, especially those with lactose intolerance or dairy allergies.

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