Nursing Elites

1. A nurse is providing discharge teaching to a client who has a new prescription for Warfarin. Which of the following statements should the nurse include?

• A. You should avoid taking aspirin for headaches while on this medication.
• B. You should use a soft toothbrush to brush your teeth.
• C. You should avoid foods that are rich in vitamin K.
• D. You should avoid prolonged exposure to sunlight.

Correct answer: B

Rationale: The correct statement to include in discharge teaching for a client prescribed Warfarin is to use a soft toothbrush to prevent gum bleeding. Warfarin is an anticoagulant that increases the risk of bleeding, so using a soft toothbrush can help prevent gum injury and bleeding. Choice A is incorrect because aspirin, another blood-thinning medication, should generally be avoided while on Warfarin to reduce the risk of bleeding. Choice C is incorrect because clients on Warfarin should maintain a consistent intake of vitamin K-rich foods rather than avoid them completely. Choice D is unrelated to the medication and not a priority teaching point for a client prescribed Warfarin.

2. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: The correct instruction for taking Colesevelam is to take it with food and at least one glass of water. This helps to ensure proper absorption and reduce the risk of gastrointestinal side effects. Option A is incorrect because Digoxin and Colesevelam should not be taken together. Option B is irrelevant to the administration of Colesevelam. Option C is unrelated to the specific instructions for taking Colesevelam.

3. A client has a new prescription for Metronidazole. Which of the following instructions should be included in the discharge teaching?

• A. Avoid drinking alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Avoid dairy products while taking this medication.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction to include in the discharge teaching for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Drinking alcohol with Metronidazole can result in a disulfiram-like reaction, leading to symptoms such as nausea, vomiting, and flushing. Therefore, it is crucial for the client to abstain from alcohol consumption during the course of treatment with Metronidazole.

4. A hospitalized client has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should be prepared for transfusion?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the appropriate blood product for a client with an elevated aPTT as it contains various coagulation factors that can help correct coagulopathies and prevent bleeding. Elevated aPTT indicates a deficiency in specific clotting factors, and fresh frozen plasma is rich in these factors. Whole blood, platelets, and packed red blood cells do not contain the necessary coagulation factors to correct an elevated aPTT, so they are not indicated in this situation.

5. Which drug classes are NOT typically used to treat angina?

• A. Calcium channel blockers
• B. Organic nitrates
• C. Alpha blockers
• D. Beta blockers

Correct answer: C

Rationale: Angina is primarily treated with calcium channel blockers, organic nitrates, and beta blockers. Alpha blockers are not commonly used in the treatment of angina. Calcium channel blockers help dilate blood vessels, decreasing the workload on the heart. Organic nitrates relax and widen blood vessels, improving blood flow and reducing the heart's workload. Beta blockers reduce the heart rate and blood pressure, decreasing the heart's demand for oxygen. Alpha blockers are more commonly used to treat conditions like hypertension and benign prostatic hyperplasia.

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