Nursing Elites

1. A client has been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

2. A healthcare professional is reviewing the medication list of a client who has a new prescription for Digoxin to treat heart failure. Which of the following medications places the client at risk for Digoxin toxicity?

• A. Spironolactone
• B. Calcium channel blockers
• C. Loop diuretics
• D. ACE inhibitors

Correct answer: C

Rationale: Loop diuretics, such as Furosemide, can increase the risk of Digoxin toxicity by causing hypokalemia. Hypokalemia enhances the toxic effects of Digoxin on the heart, leading to an increased risk of Digoxin toxicity. Spironolactone (Choice A) is less likely to cause hypokalemia and does not significantly increase the risk of Digoxin toxicity. Calcium channel blockers (Choice B) and ACE inhibitors (Choice D) do not directly increase the risk of Digoxin toxicity through hypokalemia; therefore, they are not the medications that place the client at risk for Digoxin toxicity.

3. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?

• A. Stop the infusion.
• B. Call the provider.
• C. Elevate the head of the bed.
• D. Auscultate breath sounds.

Correct answer: A

Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.

4. A client informs the nurse about taking Gingko Biloba. Which of the following medications is contraindicated for a client taking Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: The correct answer is B, Warfarin. Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction. Gingko Biloba can suppress coagulation and increase the risk of bleeding or hemorrhage when taken with anticoagulants like Warfarin. Acetaminophen (choice A), Digoxin (choice C), and Lisinopril (choice D) do not have significant interactions with Gingko Biloba.

5. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?

• A. Use a blood pressure cuff to distend the veins.
• B. Select the antecubital area to insert the IV catheter.
• C. Distend the veins by using a blood pressure cuff.
• D. Direct the client to lower his arm below his heart.

Correct answer: C

Rationale: The correct answer is C. The healthcare professional should distend the veins using a blood pressure cuff to make the veins more visible and accessible for IV catheter insertion. This technique helps reduce the risk of overfilling the vein, which can lead to complications such as hematoma formation. Choices A, B, and D are incorrect because while selecting the antecubital area is often appropriate for IV insertion in adults, the key action in this scenario is to distend the veins using a blood pressure cuff to facilitate the procedure.

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