Nursing Elites

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

• A. Rinse your mouth after each use of this medication.
• B. Limit fluid intake while taking this medication.
• C. Increase your intake of vitamin B12 while taking this medication.
• D. You can take the medication as needed.

Correct answer: A

Rationale: The correct instruction the nurse should provide is to rinse the mouth after each use of Beclomethasone. This practice helps reduce the risk of developing oral fungal infections associated with inhaled corticosteroids. Choice B is incorrect because there is no need to limit fluid intake while taking this medication. Choice C is incorrect as there is no specific indication to increase vitamin B12 intake with Beclomethasone. Choice D is incorrect as Beclomethasone should be used according to the prescribed schedule, not as needed.

2. What instruction should the healthcare provider include to minimize an adverse effect of Clomipramine for OCD in an adolescent client?

• A. Wear sunglasses when outdoors.
• B. Check your temperature daily.
• C. Take this medication in the morning.
• D. Add extra calories to your diet.

Correct answer: A

Rationale: The correct answer is A: 'Wear sunglasses when outdoors.' To minimize the anticholinergic effect of Clomipramine, the client should wear sunglasses when outdoors to reduce photophobia. This adverse effect is common with tricyclic antidepressant (TCA) use. Choices B, C, and D are incorrect. Checking temperature daily, timing of medication intake, or adding extra calories to the diet are not directly related to minimizing adverse effects of Clomipramine.

3. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and osteoporosis are conditions where estrogen therapy may actually be indicated. Dysfunctional uterine bleeding is another condition where estrogen therapy can be used to help regulate menstrual bleeding.

4. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: An adverse effect of prochlorperazine is acute dystonia, which is evidenced by spasms of the muscles in the face, neck, and tongue. Diphenhydramine is used to suppress extrapyramidal effects of prochlorperazine, making it the most appropriate choice to address the client's spasms. Fomepizole is used in methanol or ethylene glycol poisoning, not for acute dystonia. Naloxone is an opioid antagonist used for opioid overdose, not for acute dystonia. Phytonadione is vitamin K, used for the reversal of warfarin, not for acute dystonia.

5. A client has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

• A. Increase intake of protein-rich foods.
• B. Expect muscle twitching to occur.
• C. Take this medication with food.
• D. Anticipate relief of manifestations in 24 hours.

Correct answer: C

Rationale: The correct instruction the nurse should include is to take Levodopa/Carbidopa with food. Taking this medication with food helps reduce gastrointestinal side effects. Instructing the client to take the medication with food promotes better tolerance and absorption of the drug. Choice A is incorrect because increasing protein-rich foods is not specifically related to the administration of this medication. Choice B is incorrect as muscle twitching is not a common side effect of Levodopa/Carbidopa. Choice D is incorrect because relief of manifestations may take longer than 24 hours to occur.

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