Nursing Elites

1. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

2. A client has a new prescription for Metoprolol. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Avoid sudden discontinuation of the medication.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Metoprolol. Metoprolol is a beta-blocker that should be tapered off gradually to prevent rebound hypertension and other cardiac issues. Abruptly stopping Metoprolol can lead to serious complications, so it is essential for the client to follow the healthcare provider's guidance on discontinuation. Choice A is incorrect because Metoprolol can be taken with or without food. Choice B is incorrect as Metoprolol is not typically associated with causing hyperglycemia. Choice D is also incorrect as there is no need to increase potassium-rich foods specifically due to taking Metoprolol.

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

• A. Take this medication on an empty stomach.
• B. Take this medication in the morning.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: Lovastatin should be taken at bedtime because cholesterol production in the liver is highest at night, making the medication more effective in reducing cholesterol levels. By taking it at bedtime, the medication aligns with the body's natural rhythm of cholesterol synthesis, optimizing its therapeutic effects.

4. What is the therapeutic use of Phenytoin?

• A. Replacement in hypothyroidism to restore normal hormonal balance
• B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
• C. Diminished seizure activity, termination of ventricular arrhythmias
• D. Prevention of thrombus formation, prevention of extension of existing thrombi

Correct answer: C

Rationale: Phenytoin is primarily used to diminish seizure activity and is effective in terminating ventricular arrhythmias. It works by stabilizing neuronal membranes, reducing repetitive neuronal firing, and limiting the spread of seizure activity in the brain. While phenytoin does not have a direct role in preventing thrombus formation or extending existing thrombi, it is crucial in managing seizures and certain arrhythmias.

5. A healthcare professional is preparing to administer furosemide 80 mg PO daily. The available furosemide oral solution is 10 mg/1 mL. How many mL should the healthcare professional administer?

• A. 8 mL
• B. 10 mL
• C. 6 mL
• D. 12 mL

Correct answer: A

Rationale: To determine the volume to administer, divide the desired dose by the available concentration. In this case, (80 mg / 10 mg/mL) = 8 mL. Therefore, the healthcare professional should administer 8 mL of furosemide oral solution. Choice B (10 mL), C (6 mL), and D (12 mL) are incorrect as they do not accurately calculate the volume needed based on the provided concentration of the solution.

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