Nursing Elites

1. A client with hypertension is prescribed clonidine (Catapres) transdermal patch. Which statement by the client indicates an understanding of the medication?

• A. I should change the patch daily.
• B. I should remove the old patch before applying a new one.
• C. I should avoid alcohol consumption while using this patch.
• D. I should apply the patch to different sites each time.

Correct answer: B

Rationale: The correct answer is B. The client should remove the old clonidine (Catapres) patch before applying a new one to prevent overdose. The patch is typically changed every 7 days. Avoiding alcohol consumption is important as it can potentiate the sedative effects of clonidine. It is recommended to rotate application sites to prevent skin irritation and ensure optimal drug absorption.

2. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:

• A. Should always be taken with food or antacids
• B. Should be double-dosed if one dose is forgotten
• C. Causes orange discoloration of sweat, tears, urine, and feces
• D. May not be discontinued independently if symptoms are gone in 3 months

Correct answer: C

Rationale: Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.

3. The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

• A. Diarrhea
• B. Heartburn
• C. Flatulence
• D. Constipation

Correct answer: B

Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.

4. Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history?

• A. Gout
• B. Asthma
• C. Thrombophlebitis
• D. Myocardial infarction

Correct answer: C

Rationale: Megestrol acetate can increase the risk of thromboembolic events. Clients with a history of thrombophlebitis should not receive this medication due to the increased risk of thromboembolic events. Therefore, the nurse should contact the registered nurse if thrombophlebitis is documented in the client's history to ensure appropriate medication management.

5. A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the healthcare provider's office that a dose was taken this morning. The nurse determines that:

• A. The client should reschedule the appointment.
• B. A lower dose of allergen will need to be injected.
• C. A higher dose of allergen will need to be injected.
• D. The client should have the skin test read a day later than usual.

Correct answer: A

Rationale: Fexofenadine, an antihistamine, can cause false-negative readings in allergy skin testing and should be discontinued 3 days prior. Therefore, the client should reschedule the appointment to ensure accurate test results.

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