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 is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?

• A. It is not necessary to avoid the use of alcohol.
• B. The medication should be taken with meals to decrease flushing.
• C. Clay-colored stools are a common side effect and should not be of concern.
• D. Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing.

Correct answer: D

Rationale: Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30 minutes before taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it will enhance this side effect. The medication should be taken with meals, this will decrease gastrointestinal upset. Taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic dysfunction and should be immediately reported to the health care provider (HCP).

3. A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which of the following vital signs is most important for the nurse to check before administering the medication?

• A. Temperature
• B. Respirations
• C. Blood pressure
• D. Radial pulse rate

Correct answer: C

Rationale: The correct answer is checking the client's blood pressure (C) before administering another nitroglycerin tablet. Nitroglycerin can cause hypotension, and monitoring blood pressure is crucial to prevent a sudden drop in blood pressure, especially when giving another dose of nitroglycerin.

4. The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?

• A. Constipation
• B. Abdominal pain
• C. An episode of diarrhea
• D. Hematest-positive nasogastric tube drainage

Correct answer: C

Rationale: Loperamide hydrochloride (Imodium) is an antidiarrheal medication commonly used to manage episodes of diarrhea. It works by slowing down gut movement and reducing the frequency of bowel movements. Loperamide is not indicated for constipation, abdominal pain, or hematest-positive nasogastric tube drainage. It is specifically useful in acute and chronic diarrhea, such as in cases of inflammatory bowel disease, to help control symptoms and decrease fluid loss.

5. A client is learning how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?

• A. Withdraws the NPH insulin first
• B. Withdraws the regular insulin first
• C. Injects air into the NPH insulin vial first
• D. Injects an amount of air equal to the desired dose of insulin into the vial

Correct answer: A

Rationale: When mixing regular insulin with another insulin preparation, it is crucial to withdraw the regular insulin first to prevent contamination. NPH insulin should be drawn after the regular insulin to maintain the integrity of each insulin type. Therefore, if the client withdraws the NPH insulin first, it indicates the need for further teaching. Choice B is correct as withdrawing regular insulin first is the appropriate step. Choice C is incorrect as air should be injected into the vial containing the regular insulin to maintain pressure. Choice D is incorrect as injecting air equal to the desired dose of insulin into the vial is a correct step in preparing the insulin for withdrawal.

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