Nursing Elites

1. A client reports taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: The correct answer is C, Warfarin. Aspirin increases the effect of anticoagulants like warfarin by inhibiting platelet aggregation, leading to an increased risk of bleeding. Therefore, the use of aspirin is generally contraindicated for clients taking warfarin. Choices A, B, and D are not contraindicated with aspirin. Digoxin, Metformin, and Nitroglycerin do not have significant interactions with Aspirin, unlike Warfarin, making them safe to use concomitantly.

2. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.

3. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: When taking colesevelam, it should be administered with food and at least 8 oz of water to ensure proper absorption and reduce the risk of gastrointestinal side effects. Taking colesevelam with food also helps in binding to bile acids efficiently. Options A, B, and C are incorrect because they do not provide the necessary instruction for taking colesevelam correctly or monitoring specific side effects associated with this medication.

4. A client has a new prescription for Buspirone to treat Anxiety. Which of the following information should the nurse include?

• A. Take this medication on an empty stomach.
• B. Expect optimal therapeutic effects within 24 hours.
• C. Take this medication as needed for anxiety.
• D. This medication has a low risk for dependency.

Correct answer: D

Rationale: When educating a client about Buspirone, the nurse should highlight that this medication has a low risk for physical or psychological dependence or tolerance. This information is crucial for the client to understand the safety profile of Buspirone compared to other medications used for anxiety.

5. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: Fever is a key symptom of serotonin syndrome, a potentially serious condition that can occur with the use of SSRIs like Sertraline. Serotonin syndrome is characterized by excessive levels of serotonin in the body, leading to symptoms such as fever, agitation, confusion, tremors, and sweating. If a client on Sertraline presents with fever, the nurse should consider the possibility of serotonin syndrome and take appropriate actions such as notifying the healthcare provider and monitoring the client closely. Bruising, abdominal pain, and rash are not typically associated with serotonin syndrome and are more likely to be indicative of other conditions or side effects.

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