Nursing Elites

1. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. It is essential to alternate nostrils daily when inhaling the medication to ensure equal distribution and optimal absorption. This technique helps prevent irritation and congestion in one nostril and enhances the effectiveness of the medication. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed, applied topically, or taken as a liquid medication after meals. Therefore, instructing the client to alternate nostrils during inhalation is the most appropriate teaching for this medication.

2. A client is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should be administered to suppress normal flora in the GI tract?

• A. Kanamycin
• B. Gentamicin
• C. Neomycin
• D. Tobramycin

Correct answer: C

Rationale: The correct answer is C: Neomycin. Neomycin, an aminoglycoside antibiotic, is administered orally before GI surgery to eliminate the normal flora in the large intestine. This helps reduce the risk of postoperative infections by decreasing the bacterial load in the gut. Choices A, B, and D (Kanamycin, Gentamicin, Tobramycin) are not typically used to suppress normal flora in the GI tract before colorectal surgery.

3. A healthcare professional is caring for a client who is receiving heparin therapy. Which of the following laboratory tests should the healthcare professional monitor to evaluate the therapeutic effect of heparin?

• A. PT/INR
• B. Platelet count
• C. aPTT
• D. WBC count

Correct answer: C

Rationale: The correct test to monitor the therapeutic effect of heparin is the activated partial thromboplastin time (aPTT). Heparin's action is to prolong the clotting time, and aPTT reflects this effect. Monitoring aPTT helps ensure that the client is within the therapeutic range to prevent clot formation while minimizing the risk of bleeding complications. PT/INR is used to monitor warfarin therapy, platelet count assesses for potential thrombocytopenia, and WBC count evaluates for signs of infection or inflammation, not the therapeutic effect of heparin.

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

• A. Take this medication with food.
• B. Avoid taking aspirin while on this medication.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: When a client is prescribed Clopidogrel, an antiplatelet medication, the nurse should instruct them to avoid taking aspirin or other NSAIDs. This is because both medications can increase the risk of bleeding when taken together, potentially leading to serious health complications. Therefore, it is crucial for the client to follow this instruction to ensure their safety and well-being while on Clopidogrel. Choices A, C, and D are incorrect because taking Clopidogrel with food, avoiding foods high in potassium, or taking the medication at bedtime are not specific instructions related to the safe use of Clopidogrel and do not address the potential interaction with aspirin, which is essential for the client's well-being.

5. A client is being discharged with a new prescription for Clopidogrel. Which of the following instructions should the nurse include?

• A. Avoid taking aspirin while on this medication.
• B. Take this medication with food.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed Clopidogrel is to avoid taking aspirin while on this medication. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs can potentiate the risk of bleeding, so they should be avoided while taking Clopidogrel to prevent adverse effects. Choices B, C, and D are incorrect because Clopidogrel does not need to be taken with food, there is no specific dietary restriction related to potassium, and the timing of administration (bedtime) is not a critical instruction for this medication.

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