Nursing Elites

1. A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?

• A. Taking four medications decreases the risk of a severe allergic reaction.
• B. Taking four medications reduces the chance that the bacteria will become resistant.
• C. Taking four medications reduces the risk of adverse reactions.
• D. Taking four medications decreases the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: When treating tuberculosis, using a combination of multiple medications is crucial to reduce the risk of bacterial resistance. The use of four medications helps to target the bacteria from different angles, making it harder for them to develop resistance to the treatment. This approach is essential to ensure the effectiveness of the treatment regimen and to prevent the spread of drug-resistant strains of tuberculosis. Choices A, C, and D are incorrect because the primary reason for using multiple medications in tuberculosis treatment is to prevent the development of bacterial resistance, not to decrease the risk of allergic reactions, adverse reactions, or affecting the tuberculin skin test results.

2. A client has a new prescription for Ferrous sulfate. Which of the following instructions should be included?

• A. Take this medication with milk.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication with antacids.

Correct answer: B

Rationale: The correct answer is B: 'Take this medication on an empty stomach.' Ferrous sulfate is best absorbed on an empty stomach. Instruct the client to take it 1 hour before or 2 hours after meals to maximize absorption and avoid interactions with food or beverages that may decrease absorption. Choice A is incorrect because taking Ferrous sulfate with milk can decrease its absorption. Choice C is incorrect as there is no specific benefit to taking it before bedtime. Choice D is incorrect as antacids can interfere with the absorption of Ferrous sulfate.

3. A client has a new prescription for Iron supplements. Which of the following instructions should be included in the teaching?

• A. Take the medication with a glass of orange juice.
• B. Avoid taking the medication with milk.
• C. Increase fiber intake to prevent constipation.
• D. Expect stools to be dark.

Correct answer: C

Rationale: The correct answer is to increase fiber intake to prevent constipation when taking iron supplements. Iron supplements can lead to constipation as a common side effect. Increasing fiber intake helps promote healthy bowel movements and counteracts the constipating effects of iron. Choice A is incorrect because iron absorption is hindered by calcium found in milk. Choice B is incorrect as orange juice enhances iron absorption due to its vitamin C content. Choice D is incorrect as iron supplements can cause stools to appear dark, not bright red.

4. A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

5. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following foods should the provider instruct the client to avoid?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients taking Warfarin should avoid foods high in vitamin K, such as broccoli, as they can interfere with the effectiveness of the medication. Vitamin K can counteract the anticoagulant effects of Warfarin, potentially leading to blood clotting issues. Broccoli is rich in vitamin K, so its consumption should be consistent to avoid fluctuations in the medication's effectiveness. Bananas, chicken, and potatoes are not known to significantly interact with Warfarin and do not pose a risk of affecting its anticoagulant properties.

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