Nursing Elites

1. A client is prescribed Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication with food.
• B. Store the medication in a cool, dry place.
• C. Swallow the tablets whole.
• D. Take one tablet every 5 minutes up to three doses for chest pain.

Correct answer: D

Rationale: During a chest pain episode, the client should take one nitroglycerin tablet sublingually every 5 minutes up to a total of three doses. If chest pain persists after three doses, emergency medical attention should be sought. Nitroglycerin should not be swallowed but allowed to dissolve under the tongue for rapid absorption. Storing the medication in a cool, dry place helps maintain its effectiveness.

2. A healthcare professional is educating a client who has a new prescription for Vitamin B12 injections. Which of the following statements should the healthcare professional include?

• A. Take the medication with a full glass of water.
• B. You will need to take this medication for the rest of your life.
• C. Expect a metallic taste in your mouth.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is B: 'You will need to take this medication for the rest of your life.' Clients with conditions like pernicious anemia or other causes of vitamin B12 deficiency may require lifelong cyanocobalamin supplementation to prevent deficiency. This is because their bodies are unable to absorb B12 from dietary sources adequately, necessitating ongoing injections to maintain optimal B12 levels. Choices A, C, and D are incorrect. A full glass of water is not necessary for Vitamin B12 injections. Metallic taste in the mouth is not a common side effect of Vitamin B12 injections, and there is no need to avoid consuming dairy products specifically in relation to Vitamin B12 injections.

3. A drug ending in the suffix (navir) is considered a ______.

• A. Antidepressant
• B. Protease inhibitor
• C. Beta antagonist
• D. H antagonist

Correct answer: B

Rationale: When a drug name ends in the suffix -navir, it indicates that the drug is a protease inhibitor. Protease inhibitors are commonly used in antiviral therapy to treat infections by inhibiting viral replication. Therefore, the correct answer is B: Protease inhibitor.

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

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. This medication can cause esophageal irritation, and maintaining an upright position for at least 30 minutes helps prevent complications such as esophagitis or esophageal ulcers. Choice A is incorrect because Alendronate should be taken in the morning on an empty stomach. Choice C is incorrect because Alendronate should be taken on an empty stomach, preferably 30 minutes before the first food, beverage, or medication of the day. Choice D is incorrect because while calcium intake is important, it is not a specific instruction related to taking Alendronate.

5. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

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