Nursing Elites

1. A client has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a non-hairy area.
• B. Change the patch every 72 hours.
• C. Avoid exposure to heat sources.
• D. Do not cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction the nurse should include for a client using a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, potentially causing an overdose. Instructing the client to avoid heat sources is crucial to ensure their safety and the effectiveness of the medication. Choices A, B, and D are incorrect because applying the patch to a non-hairy area, changing it every 72 hours, and not cutting the patch are general guidelines for using transdermal patches but do not specifically address the unique risks associated with Fentanyl patches.

2. A healthcare provider is providing discharge instructions to a client who is prescribed Warfarin. Which of the following dietary instructions should the provider include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is to avoid foods high in vitamin K. Vitamin K can interfere with the effectiveness of Warfarin by counteracting its anticoagulant effects. Foods high in vitamin K, such as leafy green vegetables, should be limited in the diet of individuals taking Warfarin to maintain a consistent level of the medication's effectiveness. Choices A, C, and D are incorrect as increasing intake of leafy green vegetables (choice A) and dairy products (choice C) may increase the intake of vitamin K, which is not recommended, and avoiding foods high in iron (choice D) is not directly related to Warfarin therapy.

3. A client is taking atorvastatin for hyperlipidemia. Which of the following findings should the nurse report to the provider immediately?

• A. Headache
• B. Nausea
• C. Muscle pain
• D. Diarrhea

Correct answer: C

Rationale: Muscle pain should be reported immediately as it can indicate rhabdomyolysis, a severe adverse effect of atorvastatin. Rhabdomyolysis is characterized by muscle pain, weakness, and can lead to serious complications such as kidney damage, making it crucial for the nurse to notify the provider promptly. Headache, nausea, and diarrhea are common side effects of atorvastatin and do not require immediate reporting unless severe or persistent.

4. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

• A. Increased renal secretion
• B. Increased medication-metabolizing enzymes
• C. Liver failure
• D. Peripheral vascular disease

Correct answer: C

Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.

5. A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included?

• A. Take the medication with food to reduce nausea.
• B. Take the medication first thing in the morning on an empty stomach.
• C. Take the medication with a full glass of milk.
• D. Take the medication with meals.

Correct answer: B

Rationale: Alendronate should be taken first thing in the morning on an empty stomach to maximize absorption. Taking it with food, milk, or meals can reduce its effectiveness by impairing absorption. Therefore, advising the client to take it on an empty stomach is crucial for optimal therapeutic outcomes.

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