Nursing Elites

1. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

2. When teaching a client with a new prescription for nitroglycerin patches, which of the following instructions should the nurse include?

• A. Apply the patch at the same time every day.
• B. Rotate the application site daily.
• C. Remove the patch for 12 hours each day.
• D. Cut the patch in half if needed.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for nitroglycerin patches is to rotate the application site daily. This is important to prevent skin irritation and ensure optimal absorption of the medication. Applying the patch at the same time every day (Choice A) is not necessary for nitroglycerin patches. Removing the patch for 12 hours each day (Choice C) would disrupt the continuous delivery of medication. Cutting the patch in half (Choice D) can alter the dose and is not recommended unless directed by a healthcare provider.

3. When educating a client who has a new prescription for Hydrochlorothiazide, which of the following statements should the nurse include?

• A. Take this medication in the morning.
• B. You may need to increase your intake of potassium.
• C. This medication may cause drowsiness.
• D. Avoid consuming grapefruit.

Correct answer: B

Rationale: The correct statement to include when educating a client with a new prescription for Hydrochlorothiazide is that they may need to increase their intake of potassium. Hydrochlorothiazide is a thiazide diuretic that can lead to potassium loss. Monitoring potassium levels and increasing potassium intake if necessary can help prevent complications associated with hypokalemia. Option A is not directly related to the medication's specific instructions. Option C is incorrect as Hydrochlorothiazide typically does not cause drowsiness. Option D is unrelated, as there is no interaction between Hydrochlorothiazide and grapefruit.

4. 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.

5. When teaching a client how to use nitroglycerin transdermal ointment for angina, which instruction should the nurse include?

• A. Remove the prior dose before applying a new dose.
• B. Rub the ointment directly into your skin until it is no longer visible.
• C. Cover the applied ointment with a clean gauze pad.
• D. Apply the ointment to the same skin area each time.

Correct answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new dose. This helps prevent toxicity by ensuring the client does not inadvertently apply an excessive amount of nitroglycerin.

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