Nursing Elites

1. A client with schizophrenia is being taught strategies to cope with anticholinergic effects of Fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: Chewing sugarless gum is an effective strategy to manage dry mouth, a common anticholinergic effect of Fluphenazine. By stimulating saliva production, sugarless gum helps to moisten the mouth and alleviate the discomfort associated with dryness. This intervention can improve the client's oral health and overall comfort while taking the medication. The other options are not directly related to alleviating anticholinergic effects. Taking the medication in the morning to prevent insomnia does not address anticholinergic effects specifically. Using cooling measures to decrease fever is not relevant to managing dry mouth caused by anticholinergic effects. Taking an antacid to relieve nausea is unrelated to managing dry mouth, which is the focus of anticholinergic effects.

2. A client has a new prescription for Oxycodone/Acetaminophen. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking additional Acetaminophen while on Oxycodone/Acetaminophen. This is important to prevent exceeding the maximum recommended dose and reducing the risk of liver toxicity. Oxycodone/Acetaminophen already contains Acetaminophen, so additional intake can lead to an overdose of this component. Choices A, C, and D are incorrect. Taking the medication on an empty stomach or increasing fiber intake are not specific instructions related to this medication. Avoiding taking the medication before bedtime is not directly relevant to the combination of Oxycodone/Acetaminophen.

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

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Take the medication with orange juice to enhance absorption.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct answer is C: 'Take the medication with orange juice to enhance absorption.' Taking ferrous sulfate with orange juice helps enhance the absorption of iron due to the ascorbic acid present in the orange juice, which aids in iron absorption. This combination can help improve the effectiveness of the medication. Choice A, taking the medication with meals, may reduce gastrointestinal side effects but does not specifically enhance absorption. Choice B, taking the medication on an empty stomach, may lead to better absorption but can also increase the risk of gastrointestinal side effects. Choice D, taking the medication with a full glass of milk, is incorrect because calcium in milk can inhibit the absorption of iron.

4. A client who is receiving combination chemotherapy is exhibiting a temperature of 38.1°C (100.6°F). Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients undergoing chemotherapy due to the heightened risk of sepsis in immunocompromised individuals. Immediate assessment and intervention are crucial to prevent severe complications. Dry oral mucous membranes, nausea and vomiting, and anorexia are common side effects of chemotherapy but are not specific indicators of an oncologic emergency like a fever in this setting.

5. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

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