Nursing Elites

1. A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache?

• A. Naproxen (Aleve)
• B. Ibuprofen (Advil)
• C. Acetaminophen (Tylenol)
• D. Acetylsalicylic acid (aspirin)

Correct answer: C

Rationale: Acetaminophen is the preferred choice for pain relief in individuals taking lansoprazole for Zollinger-Ellison syndrome due to its lower risk of stomach irritation compared to NSAIDs like ibuprofen and aspirin. Naproxen, ibuprofen, and aspirin are NSAIDs that can increase the risk of stomach irritation and bleeding, which is why they are not recommended for individuals with Zollinger-Ellison syndrome who are already on lansoprazole to reduce stomach acid production.

2. A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?

• A. Lung sounds
• B. Blood pressure
• C. Blood ammonia level
• D. Serum potassium level

Correct answer: C

Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.

3. A client who has been taking isoniazid (INH) for tuberculosis asks the nurse about the medication. Which statement by the client indicates the need for further teaching?

• A. I should limit my alcohol intake.
• B. I should notify my doctor if I notice a yellowish skin color.
• C. I should take the medication with an empty stomach.
• D. I should notify my doctor if I experience numbness and tingling in my extremities.

Correct answer: C

Rationale: Isoniazid (INH) is best absorbed when taken on an empty stomach. However, if gastrointestinal upset occurs, it can be taken with food. Limiting alcohol intake, monitoring for jaundice, and notifying the doctor of peripheral neuropathy symptoms are all appropriate actions while taking INH.

4. A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?

• A. I will take my pills every day at the same time.
• B. I will be certain to avoid alcohol consumption.
• C. I have already called my family to pick up a Medic-Alert bracelet.
• D. I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.

Correct answer: D

Rationale: Ecotrin is an aspirin-containing product and should be avoided. Clients should avoid alcohol consumption, take prescribed medication at the same time each day, and use a Medic-Alert bracelet for emergency information.

5. A client with diabetes mellitus is prescribed Humulin NPH insulin. The client asks the nurse how to store unopened vials of insulin. The nurse instructs the client to:

• A. Freeze the insulin.
• B. Refrigerate the insulin.
• C. Store the insulin in a dark, dry place.
• D. Keep the insulin at room temperature.

Correct answer: B

Rationale: Unopened vials of insulin should be stored in the refrigerator until needed. Freezing insulin can damage it, affecting its efficacy. Storing insulin in a dark, dry place or at room temperature is not recommended as it can lead to degradation of the insulin. Refrigeration helps maintain the stability and effectiveness of insulin.

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