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 has a new prescription for Warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, not potassium. Therefore, the client needs to be cautious with foods high in vitamin K, such as green leafy vegetables, rather than foods high in potassium. Choices A, B, and D are correct statements regarding Warfarin therapy and do not indicate a need for further teaching.

3. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, what advice should the nurse provide?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods high in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The nurse should advise the client to limit aerobic activity in hot weather to prevent sodium/water depletion, which can increase the risk for Lithium toxicity. Excessive sweating and fluid loss can lead to dehydration and changes in lithium levels, potentially resulting in toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting sodium intake and decreasing fluid intake can lead to increased lithium levels and toxicity, so these are not recommended actions.

4. A client is receiving Enoxaparin for the prevention of deep vein thrombosis. Which of the following actions should the nurse take?

• A. Massage the injection site after administration.
• B. Administer the medication intramuscularly.
• C. Administer the medication into the subcutaneous tissue.
• D. Administer the medication into the deltoid muscle.

Correct answer: C

Rationale: Enoxaparin, a medication used for preventing deep vein thrombosis, should be administered into the subcutaneous tissue, typically in the abdomen. Administering the medication intramuscularly (Choice B) or into the deltoid muscle (Choice D) is incorrect because Enoxaparin is specifically formulated for subcutaneous administration. Massaging the injection site after administration (Choice A) is contraindicated as it may lead to tissue damage and affect the absorption of the medication. Therefore, the correct action is to administer the medication into the subcutaneous tissue as directed.

5. A healthcare provider is educating a client who has a new prescription for Simvastatin. Which of the following instructions should the healthcare provider include?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the healthcare provider should include is to 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Simvastatin, leading to potential side effects like muscle pain and liver damage. Instructing the client to avoid grapefruit juice helps prevent these adverse effects and ensures the medication's efficacy. Choices A, C, and D are incorrect because taking Simvastatin with food, at a specific time, or increasing potassium-rich foods intake are not essential instructions for this medication.

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