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. What is a desired outcome of the drug Phenytoin?

• A. Decrease symptoms of PTSD
• B. Resolution of signs of infection
• C. Decrease or cessation of seizures without excessive sedation
• D. Prevention or relief of bronchospasm

Correct answer: C

Rationale: The correct answer is C: Decrease or cessation of seizures without excessive sedation. Phenytoin is primarily used as an antiepileptic medication to manage and prevent seizures. It does not directly impact symptoms of PTSD (Choice A), resolution of signs of infection (Choice B), or prevention or relief of bronchospasm (Choice D). Therefore, the desired outcome of Phenytoin is to control seizures effectively while avoiding excessive sedation.

3. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of this medication. Verapamil is a calcium channel blocker used to treat hypertension, and dietary fiber helps maintain bowel regularity and prevent constipation that may occur as a side effect of the medication.

4. When teaching a patient to take their own pulse, which medication should the nurse instruct them to monitor? (Hint: if pulse is <60 or >100, the patient should contact their healthcare provider before taking the medication)

• A. Digoxin
• B. Lithium
• C. Montelukast
• D. Phenytoin

Correct answer: A

Rationale: It is essential for patients taking Digoxin to monitor their pulse regularly. If their pulse falls below 60 or exceeds 100 beats per minute, they should contact their healthcare provider immediately. This is crucial due to Digoxin's potential to affect heart rate, making pulse monitoring a vital aspect of patient care while on this medication.

5. A client has a new prescription for Hydralazine. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hyperglycemia
• C. Hyponatremia
• D. Constipation

Correct answer: A

Rationale: Corrected Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as an adverse effect. The client should monitor their pulse and report any significant increases, as tachycardia can indicate a severe adverse reaction to the medication. Choice B, Hyperglycemia, is not a common adverse effect of Hydralazine. Choice C, Hyponatremia, and Choice D, Constipation, are also not typically associated with Hydralazine use. Therefore, the correct answer is A: Tachycardia.

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