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 taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication?

• A. Increased TSH level
• B. Decreased ALT level
• C. Hypoglycemia
• D. Hyperlipidemia

Correct answer: D

Rationale: The correct answer is D: Hyperlipidemia. Ritonavir, a protease inhibitor used in HIV treatment, can lead to hyperlipidemia, characterized by increased cholesterol and triglyceride levels. Monitoring lipid levels is crucial to identify and manage this potential adverse effect. Choices A, B, and C are incorrect because Ritonavir is not known to cause an increased TSH level, decreased ALT level, or hypoglycemia as adverse effects.

3. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.

4. A client has a new prescription for Ramelteon and is receiving teaching from a nurse. The nurse should instruct the client to avoid which of the following foods while taking this medication?

• A. Baked potato
• B. Fried chicken
• C. Whole-grain bread
• D. Citrus fruits

Correct answer: B

Rationale: The correct answer is B: Fried chicken. High-fat foods like fried chicken can prolong the absorption of Ramelteon, potentially reducing its effectiveness. It is important to avoid such foods to ensure the medication works as intended.

5. A healthcare professional is teaching a client who has a new prescription for Clopidogrel. Which of the following laboratory values should the healthcare professional monitor to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication that works by preventing blood clots. Monitoring the patient's platelet count is essential because a decrease in platelet count can increase the risk of bleeding. By assessing the platelet count, the healthcare professional can detect any potential adverse effects related to the medication and take appropriate actions to prevent complications. White blood cell count, hemoglobin, and blood glucose levels are not directly affected by Clopidogrel, so they are not the primary values to monitor for potential adverse effects of this medication.

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