Nursing Elites

1. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching plan?

• A. Avoid taking folic acid supplements.
• B. Report any signs of infection immediately.
• C. Take the medication with a full meal.
• D. Limit fluid intake while on this medication.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the client's teaching plan when taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. It is important for the client to promptly report any signs of infection to receive timely medical intervention. Choice A is incorrect because folic acid supplements are often recommended to reduce side effects of methotrexate. Choice C is incorrect as methotrexate is usually taken on an empty stomach unless the client experiences gastrointestinal upset. Choice D is incorrect as there is no need to limit fluid intake while on methotrexate; in fact, maintaining adequate fluid intake is important to prevent complications such as kidney damage.

2. Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?

• A. Platelet count
• B. Triglyceride level
• C. Complete blood count
• D. White blood cell count

Correct answer: B

Rationale: Before administering Isotretinoin, it is important to check the client's triglyceride levels. Isotretinoin is known to elevate triglyceride levels, hence monitoring them before and periodically during treatment is essential to prevent potential adverse effects.

3. When a client is taking lansoprazole (Prevacid), which question should the nurse ask during data collection to determine medication effectiveness?

• A. Has your appetite increased?
• B. Are you experiencing any heartburn?
• C. Do you have any problems with vision?
• D. Do you experience any leg pain when walking?

Correct answer: B

Rationale: When a client is taking lansoprazole (Prevacid), a gastric acid pump inhibitor used to treat gastroesophageal reflux disease (GERD), the nurse should ask if the client is experiencing any heartburn to determine medication effectiveness. Heartburn is a common symptom of GERD, and the reduction of heartburn indicates the effectiveness of lansoprazole in managing acid reflux symptoms. Choices A, C, and D are not relevant to assessing the effectiveness of lansoprazole for GERD.

4. A client is taking ticlopidine hydrochloride (Ticlid). The nurse tells the client to avoid which of the following while taking this medication?

• A. Vitamin C
• B. Vitamin D
• C. Acetaminophen (Tylenol)
• D. Acetylsalicylic acid (aspirin)

Correct answer: D

Rationale: Ticlopidine hydrochloride is a platelet aggregation inhibitor. Aspirin or any aspirin-containing product should be avoided as they can precipitate or aggravate bleeding by affecting platelet function and increasing the risk of bleeding complications.

5. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which statement by the client indicates a need for further teaching?

• A. I will avoid foods high in vitamin K.
• B. I will take the medication at the same time each day.
• C. I will use an electric razor to shave.
• D. I will take aspirin if I have a headache.

Correct answer: D

Rationale: Clients taking warfarin (Coumadin) should avoid aspirin unless prescribed by their healthcare provider, as it can increase the risk of bleeding. The other statements are correct and do not indicate a need for further teaching. Taking aspirin along with warfarin can potentiate the anticoagulant effects of warfarin, leading to an increased risk of bleeding complications.

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