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 Dabigatran. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Store the capsules in a pill organizer.
• C. Crush the medication before swallowing.
• D. Expect frequent headaches while taking this medication.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with food.' Taking Dabigatran with food is recommended to reduce gastrointestinal discomfort, a common side effect associated with this medication. Food can help minimize stomach irritation and improve tolerability. Choices B, C, and D are incorrect. Storing the capsules in a pill organizer (B) is a good practice for organization but not a specific instruction for this medication. Crushing the medication before swallowing (C) is not recommended for Dabigatran as it is available as a capsule and should be swallowed whole. Expecting frequent headaches while taking this medication (D) is not a common side effect of Dabigatran and should not be anticipated.

3. A client has a new prescription for Nitrofurantoin. Which of the following instructions should be included?

• A. Take this medication with food.
• B. Avoid dairy products while taking this medication.
• C. Take this medication at bedtime.
• D. Increase your intake of vitamin C.

Correct answer: A

Rationale: Nitrofurantoin should be taken with food to enhance absorption and reduce gastrointestinal side effects. Taking it with a meal or a snack can help minimize stomach upset. Instructing the client to take the medication with food ensures optimal effectiveness and tolerability of the drug. Choice B is incorrect because there is no specific interaction between Nitrofurantoin and dairy products. Choice C is incorrect as there is no requirement to take Nitrofurantoin at bedtime. Choice D is also incorrect as increasing vitamin C intake is not necessary or relevant to taking Nitrofurantoin.

4. 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 the medication. Dietary fiber can help maintain bowel regularity and alleviate constipation.

5. A client has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Sodium level of 140 mEq/L
• D. Creatinine level of 1.0 mg/dL

Correct answer: A

Rationale: An INR of 4.0 is above the therapeutic range for a client on Warfarin, indicating an increased risk of bleeding. This finding requires immediate reporting to the provider for appropriate intervention to prevent complications associated with excessive anticoagulation. Potassium, sodium, and creatinine levels are within normal ranges and are not directly related to the risk of bleeding in a client on Warfarin therapy.

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