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 has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Sodium level of 140 mEq/L
• D. Creatinine level of 1.0 mg/dL

Correct answer: A

Rationale: An INR of 4.0 is above the therapeutic range for a client on Warfarin, indicating an increased risk of bleeding. This finding requires immediate reporting to the provider for appropriate intervention to prevent complications associated with excessive anticoagulation. Potassium, sodium, and creatinine levels are within normal ranges and are not directly related to the risk of bleeding in a client on Warfarin therapy.

3. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

4. A client has a new prescription for Calcitonin-Salmon for Osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Administer the medication intramuscularly.
• B. Swallow the medication whole.
• C. Inject the medication subcutaneously.
• D. Expect nasal bleeding with this medication.

Correct answer: C

Rationale: When teaching a client about Calcitonin-Salmon for Osteoporosis, the nurse should include instructions to inject the medication subcutaneously or administer it intranasally. Option A is incorrect because Calcitonin-Salmon is not typically administered intramuscularly. Option B is incorrect because it is not meant to be swallowed. Option D is incorrect as nasal bleeding is not an expected side effect with this medication.

5. A client has been prescribed Valsartan. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypercalcemia

Correct answer: A

Rationale: Corrected Rationale: Valsartan is an angiotensin II receptor blocker (ARB) that can lead to hyperkalemia by inhibiting the action of aldosterone. Hyperkalemia is a potential adverse effect, making it essential for the nurse to closely monitor the client's potassium levels to prevent complications such as cardiac arrhythmias. Incorrect Options Rationale: - Option B, Hypoglycemia, is not a common adverse effect of Valsartan. - Option C, Bradycardia, is not typically associated with Valsartan use. - Option D, Hypercalcemia, is not a known adverse effect of Valsartan; instead, Valsartan can lead to hyperkalemia.

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