Nursing Elites

1. A client informs a healthcare professional about taking Gingko Biloba. Which of the following medications is contraindicated for a client using Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction that can lead to suppressed coagulation and an increased risk of bleeding or hemorrhage. Warfarin is an anticoagulant, and when combined with Gingko Biloba, which also has anticoagulant properties, the risk of bleeding complications is significantly heightened. Acetaminophen (Choice A), Digoxin (Choice C), and Lisinopril (Choice D) do not have significant interactions with Gingko Biloba compared to Warfarin. Acetaminophen is a pain reliever, Digoxin is a medication for heart conditions, and Lisinopril is an ACE inhibitor for hypertension.

2. A client with a new prescription for Escitalopram for the treatment of generalized anxiety disorder is being taught by a healthcare provider. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication on an empty stomach.
• B. I will follow a low-sodium diet while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I should not crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. This gradual reduction helps minimize potential withdrawal symptoms and ensures a safer discontinuation process. Choices A, B, and D are incorrect because taking escitalopram on an empty stomach, following a low-sodium diet, and not crushing the medication are not directly related to the safe and effective use of the medication or its discontinuation process.

3. A client has a new prescription for Furosemide to treat heart failure. Which of the following laboratory results should the nurse monitor?

• A. Potassium level
• B. Sodium level
• C. Hemoglobin A1C
• D. BUN

Correct answer: A

Rationale: The nurse should monitor the client's potassium levels when taking Furosemide because the medication can lead to hypokalemia. Hypokalemia is a potential side effect of Furosemide, a loop diuretic, due to increased potassium excretion in the urine. Monitoring potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with low potassium levels. Therefore, choices B (Sodium level), C (Hemoglobin A1C), and D (BUN) are incorrect as they are not directly influenced by Furosemide therapy for heart failure.

4. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

• A. A client at 8 weeks of gestation who asks for an Influenza immunization
• B. A client who takes Prednisone and has a possible Fungal infection
• C. A client who has chronic liver disease and is taking Hydrocodone
• D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide

Correct answer: B

Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.

5. A client has a new prescription for Metformin to treat type 2 diabetes. Which of the following laboratory results should be monitored?

• A. Hemoglobin A1C
• B. Liver function tests
• C. Electrolyte levels
• D. Kidney function

Correct answer: D

Rationale: Metformin is excreted by the kidneys, and impaired kidney function can lead to an increased risk of lactic acidosis, a serious side effect. Therefore, it is important to monitor kidney function regularly while a client is on Metformin. Hemoglobin A1C is used to monitor long-term glucose control, but kidney function is the priority for monitoring Metformin therapy.

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