Nursing Elites

1. A client has been prescribed Methotrexate to treat Rheumatoid Arthritis. Which of the following instructions should the nurse provide?

• A. Take this medication with food to prevent nausea.
• B. Avoid alcohol while taking this medication.
• C. Wear sunscreen when outdoors while taking this medication.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: Methotrexate is hepatotoxic, and avoiding alcohol is crucial to prevent liver damage. However, Option A (Take this medication with food to prevent nausea) could also be correct, as Methotrexate commonly causes nausea, and taking it with food can help alleviate this side effect. However, the most important instruction is to avoid alcohol due to the risk of liver toxicity.

2. A client is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?

• A. Light yellow urine
• B. Report of tinnitus
• C. Productive cough
• D. Blue-gray skin discoloration

Correct answer: D

Rationale: Blue-gray skin discoloration is a common sign of Amiodarone toxicity, known as blue-gray discoloration, which can affect areas like the face, neck, or hands. It is important to monitor for this side effect, as it can be a visible indicator of potential toxicity. Choices A, B, and C are incorrect. Light yellow urine is not typically associated with Amiodarone toxicity. Tinnitus is not a common manifestation of Amiodarone toxicity. A productive cough is not a recognized symptom of Amiodarone toxicity.

3. A healthcare professional is reviewing the medical record of a client with a new prescription for Epoetin Alfa. Which of the following findings should the professional report to the provider?

• A. The client has a history of hypertension.
• B. The client has a hemoglobin level of 10 g/dL.
• C. The client has a history of chronic kidney disease.
• D. The client has a blood pressure of 140/90 mm Hg.

Correct answer: C

Rationale: The correct answer is C. Chronic kidney disease is a contraindication for the use of Epoetin Alfa because it can worsen hypertension, increase the risk of cardiovascular events, and lead to adverse outcomes. Epoetin Alfa is used to treat anemia by stimulating red blood cell production, but in the presence of chronic kidney disease, it can exacerbate hypertension and contribute to cardiovascular complications. Choices A, B, and D are not directly related to the contraindication of Epoetin Alfa in the presence of chronic kidney disease.

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

• A. Take the medication with a full glass of water.
• B. Avoid taking the medication with food.
• C. Discontinue the medication if diarrhea occurs.
• D. Expect to have increased appetite while taking this medication.

Correct answer: A

Rationale: The correct instruction for a client taking Clindamycin is to take the medication with a full glass of water. Clindamycin can cause esophageal irritation, so taking it with a full glass of water helps minimize this risk. Avoiding taking the medication with food is not necessary. If diarrhea occurs, clients should not discontinue the medication without consulting their healthcare provider. Clindamycin is not known to cause increased appetite.

5. While caring for a client receiving Heparin therapy, which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. PT
• B. INR
• C. aPTT
• D. Platelet count

Correct answer: C

Rationale: The nurse should monitor the aPTT (activated partial thromboplastin time) when caring for a client receiving Heparin therapy. The aPTT reflects the intrinsic pathway of the clotting cascade and is used to monitor the effectiveness of heparin, which primarily affects this pathway by potentiating antithrombin III. Monitoring the aPTT helps ensure that the client's blood is within the therapeutic range to prevent thrombus formation. Choices A, B, and D are incorrect. PT (Prothrombin Time) and INR (International Normalized Ratio) are used to monitor Warfarin therapy, not Heparin. Platelet count is important in assessing for thrombocytopenia but is not a specific indicator of Heparin therapy effectiveness.

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