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. Which of the following is the primary site of activity for the drug Warfarin?

• A. Kidney
• B. Liver
• C. Blood
• D. Heart

Correct answer: B

Rationale: Warfarin primarily affects the liver where it inhibits the synthesis of clotting factors.

3. A client has a prescription for Amoxicillin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Avoid taking the medication with milk.
• C. Expect your stools to turn clay-colored.
• D. Complete the entire course of therapy.

Correct answer: D

Rationale: The correct answer is D: Complete the entire course of therapy. It is crucial for clients to complete the entire course of amoxicillin therapy to ensure the infection is fully treated and to prevent antibiotic resistance. Prematurely stopping the antibiotic can lead to incomplete eradication of the infection, potentially causing it to return and be more difficult to treat. Choices A and B are not specific to amoxicillin and are general medication administration instructions. Choice C is not a common side effect of amoxicillin and does not require patient education.

4. A client has a new prescription for Atorvastatin. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Atorvastatin by inhibiting its metabolism in the body, leading to a higher risk of adverse effects, such as muscle pain and liver damage. Therefore, it is important for the client to avoid consuming grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect because Atorvastatin can be taken with or without food, at any time of the day, and there is no specific need to increase potassium-rich foods while on this medication.

5. A hospitalized client receiving IV heparin for a deep-vein thrombosis begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: In this scenario, the client is experiencing a serious complication of heparin therapy, likely due to heparin-induced thrombocytopenia. Protamine is the antidote for heparin and can reverse its anticoagulant effects. It is essential to administer protamine promptly to counteract the effects of heparin and manage the bleeding. Vitamin K1 is used to reverse the effects of warfarin, not heparin. Atropine is used to treat bradycardia or some types of poisoning. Calcium gluconate is used to manage hyperkalemia or calcium channel blocker toxicity, not to reverse heparin's effects.

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