Nursing Elites

1. A client has a new prescription for Alendronate to treat osteoporosis. Which of the following instructions should the nurse include?

• A. Take the medication with a full glass of water after rising in the morning.
• B. Lie down for at least 30 minutes after taking the medication.
• C. Take the medication before bedtime to reduce the risk of esophageal irritation.
• D. Crush the tablet and mix it with applesauce if having difficulty swallowing.

Correct answer: A

Rationale: The correct instruction is to take Alendronate with a full glass of water after rising in the morning. This helps reduce the risk of esophageal irritation, as the medication can cause irritation if not taken correctly. Taking it before bedtime (choice C) can increase the risk of irritation as the individual lies down. Lying down after taking the medication (choice B) can also lead to esophageal irritation. Crushing the tablet (choice D) is not recommended as Alendronate should be taken whole with a full glass of water.

2. A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.

3. A healthcare professional is educating a client who has a new prescription for warfarin. Which of the following statements should the healthcare professional include?

• A. Avoid foods high in vitamin K.
• B. Report any signs of bleeding to your healthcare provider.
• C. Use a soft toothbrush to prevent gum bleeding.
• D. Use an electric razor to prevent cuts.

Correct answer: B

Rationale: The correct statement that the healthcare professional should include when educating a client prescribed warfarin is to report any signs of bleeding to their healthcare provider. Bleeding can indicate excessive anticoagulation, which is a serious side effect of warfarin. Prompt reporting of bleeding symptoms is crucial to prevent complications. Choices A, C, and D are incorrect. While avoiding foods high in vitamin K may be important when taking warfarin due to its interaction with the medication, it is not the priority over reporting signs of bleeding. Using a soft toothbrush and electric razor are general precautions for individuals on anticoagulants but are not as critical as reporting bleeding symptoms.

4. A healthcare provider is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The provider should recognize which of the following conditions is a contraindication for taking propranolol?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Asthma. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms. Choices B, C, and D are incorrect. Glaucoma, hypertension, and tachycardia are not contraindications for taking propranolol. In fact, propranolol is commonly used to treat hypertension and tachycardia.

5. A client has a prescription for Nitroglycerin. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin involves taking one tablet at the onset of chest pain, then another tablet every 5 minutes for up to three doses. This protocol aims to relieve angina symptoms. Choice A is incorrect because waiting 15 minutes between doses may delay symptom relief. Choice C is incorrect as Nitroglycerin is not typically taken at bedtime but rather during angina episodes. Choice D is incorrect because Nitroglycerin is usually taken sublingually, so it doesn't need to be taken on an empty stomach.

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