Nursing Elites

1. A client with depression reports taking St. John's wort along with citalopram. The nurse should monitor the client for which of the following conditions as a result of an interaction between these substances?

• A. Serotonin syndrome
• B. Tardive dyskinesia
• C. Pseudoparkinsonism
• D. Acute dystonia

Correct answer: A

Rationale: When St. John's wort, an herbal supplement, is taken with citalopram, a selective serotonin reuptake inhibitor (SSRI), there is a risk of serotonin syndrome. Serotonin syndrome is a serious condition that can occur when there is an excess of serotonin in the body, leading to symptoms such as confusion, hallucinations, rapid heart rate, increased body temperature, and more. Monitoring for serotonin syndrome is crucial when these substances are taken together to prevent any potential harm to the client.

2. A client requests the creation of a living will. Which of the following actions should the nurse take?

• A. Schedule a meeting between the hospital ethics committee and the client.
• B. Evaluate the client's understanding of life-sustaining measures.
• C. Determine the client's preferences about post-mortem care.
• D. Request a conference with the client's family

Correct answer: B

Rationale: When a client requests the creation of a living will, the nurse's priority is to evaluate the client's understanding of life-sustaining measures. This involves ensuring that the client comprehends the implications of various life-sustaining interventions and can make informed decisions about their care preferences in the event they are unable to communicate them later. It is crucial for the nurse to assess the client's comprehension to ensure that the living will accurately reflects the client's wishes and values.

3. A client has chronic pancreatitis. Which of the following dietary recommendations should be made?

• A. Coffee with creamer
• B. Lettuce with sliced avocados
• C. Broiled skinless chicken breast with brown rice
• D. None of the above

Correct answer: C

Rationale: Chronic pancreatitis requires a low-fat diet to reduce stress on the pancreas. Broiled skinless chicken breast with brown rice is a suitable option as it is low in fat. Coffee with creamer and lettuce with sliced avocados are not recommended for individuals with chronic pancreatitis due to their fat content. Choosing options high in fat can exacerbate symptoms and increase the workload on the pancreas, worsening the condition.

4. A client reports that the medication the nurse is administering appears different than what they take at home. Which of the following responses should the nurse take?

• A. Did the doctor discuss with you that there was a change in this medication?
• B. I recommend that you take this medication as prescribed
• C. Do you know why this medication is being prescribed to you?
• D. I will call the pharmacist now to check on this medication

Correct answer: A

Rationale: When a client reports that the medication appears different than what they take at home, it is crucial for the nurse to ensure the safety and accuracy of the medication being administered. The most appropriate action for the nurse to take in this situation is to call the pharmacist to verify the medication, dosage, and any potential changes. This proactive step helps prevent medication errors and ensures the client's safety and well-being.

5. What is the meaning of PRN?

• A. When advice
• B. Immediately
• C. When necessary
• D. Now

Correct answer: C

Rationale: The correct meaning of PRN is 'when necessary.' The abbreviation 'PRN' comes from the Latin term 'pro re nata,' which is commonly used in medical contexts to indicate that a medication should be taken as needed, not at scheduled intervals. Choice A ('When advice') is incorrect as PRN does not refer to seeking advice. Choice B ('Immediately') is incorrect as PRN does not imply urgency. Choice D ('Now') is incorrect as PRN does not mean 'immediate' but rather 'as needed.' Therefore, the correct answer is C, 'When necessary.'

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