Nursing Elites

1. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

• A. A client at 8 weeks of gestation who asks for an Influenza immunization
• B. A client who takes Prednisone and has a possible Fungal infection
• C. A client who has chronic liver disease and is taking Hydrocodone
• D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide

Correct answer: B

Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.

2. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: The client's symptoms of face spasms after receiving Prochlorperazine indicate acute dystonia, a known side effect. Diphenhydramine is commonly administered to manage extrapyramidal symptoms, such as muscle spasms, caused by medications like Prochlorperazine. Therefore, the nurse should anticipate a prescription for Diphenhydramine to alleviate the client's symptoms. Choices A, B, and C are incorrect because Fomepizole is used in methanol or ethylene glycol poisoning, Naloxone is an opioid antagonist used in opioid overdose, and Phytonadione is vitamin K, used to reverse the effects of certain blood thinners.

3. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

4. Which of the following is not a known effect of the drug Clozapine?

• A. Agranulocytosis
• B. Antipsychotic
• C. Used for Schizophrenia
• D. Hyperactivity

Correct answer: D

Rationale: Clozapine is associated with side effects like agranulocytosis (a serious blood condition), sedation (not hyperactivity), and is used as an antipsychotic to treat schizophrenia. Hyperactivity is not a typical effect of Clozapine, making it the correct answer in this context.

5. A client is being assessed by a healthcare provider while taking Digoxin to manage heart failure. Which of the following findings is a manifestation of digoxin toxicity?

• A. Bruising
• B. Report of metallic taste
• C. Muscle pain
• D. Report of anorexia

Correct answer: D

Rationale: The correct manifestation of digoxin toxicity is anorexia, not bruising, metallic taste, or muscle pain. Other symptoms of digoxin toxicity include blurred vision, stomach pain, and diarrhea. It is crucial for healthcare providers to promptly identify these signs to prevent severe complications.

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