Nursing Elites

1. A client has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide?

• A. Take the medication on an empty stomach to decrease gastrointestinal irritation.
• B. Take the medication with orange juice to enhance absorption.
• C. Take the medication with milk.
• D. Rinse the mouth before taking the iron.

Correct answer: B

Rationale: Taking ferrous sulfate with orange juice can help increase the absorption of iron. Orange juice contains vitamin C, which aids in the absorption of iron from the medication. This combination can enhance the effectiveness of the iron supplement for a client with anemia. Option A is incorrect because taking iron on an empty stomach can cause gastrointestinal upset. Option C is incorrect because calcium in milk can inhibit iron absorption. Option D is irrelevant to enhancing iron absorption.

2. A healthcare professional is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The healthcare professional should clarify which of the following parts of the prescription with the provider?

• A. Name
• B. Dosage
• C. Route
• D. Frequency

Correct answer: D

Rationale: The prescription lacks the frequency of medication administration, which is crucial for ensuring appropriate use. In this case, the frequency of when the medication can be taken needs to be clarified with the provider to provide safe and effective care for the client with Hyperemesis Gravidarum.

3. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following over-the-counter medications should the provider instruct the client to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs like ibuprofen and opt for alternative pain relief options such as acetaminophen. Diphenhydramine and loratadine are antihistamines and are generally safe to use with Warfarin as they do not significantly increase the risk of bleeding when compared to NSAIDs like ibuprofen.

4. A client with peptic ulcer disease is being taught about managing the condition. Which of the following statements indicates an understanding of the teaching?

• A. I should eat small, frequent meals that are low in fiber.
• B. I will limit my intake of caffeine-containing beverages.
• C. I should take NSAIDs to relieve my pain.
• D. I will drink milk before bedtime to decrease acid production.

Correct answer: B

Rationale: The correct answer is B: 'I will limit my intake of caffeine-containing beverages.' Limiting intake of caffeine-containing beverages is important for managing peptic ulcer disease as caffeine can stimulate gastric acid secretion, which may worsen the condition. It is advisable to choose decaffeinated beverages and avoid caffeinated drinks to help reduce the risk of aggravating the ulcer. Choices A, C, and D are incorrect. Choice A suggests eating small, frequent meals low in fiber, which is not ideal for managing peptic ulcer disease. Choice C of taking NSAIDs is contraindicated as NSAIDs can worsen peptic ulcers. Choice D of drinking milk before bedtime to decrease acid production is a common misconception; while milk may temporarily neutralize stomach acid, it can stimulate more acid production later, making the condition worse.

5. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

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