Nursing Elites

1. A client has a new prescription for hydrochlorothiazide to treat hypertension. Which of the following instructions should be included?

• A. Take the medication in the morning.
• B. Increase intake of potassium-rich foods.
• C. Avoid sun exposure while taking this medication.
• D. Limit fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct instruction that should be included for a client prescribed hydrochlorothiazide is to increase the intake of potassium-rich foods. Hydrochlorothiazide, being a diuretic, can lead to hypokalemia by enhancing potassium excretion. Increasing consumption of potassium-rich foods like bananas or oranges can help prevent hypokalemia and maintain electrolyte balance. Choices A, C, and D are incorrect. Taking the medication in the morning is not a specific instruction related to hydrochlorothiazide. Avoiding sun exposure is more relevant for photosensitive medications, not hydrochlorothiazide. Limiting fluid intake to 1 liter per day is not necessary unless specifically advised by a healthcare provider.

2. A healthcare professional is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the healthcare professional prepare to transfuse?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the correct choice for a client with an elevated aPTT because it contains essential coagulation factors that can help correct coagulopathy and prevent bleeding. It is rich in clotting factors like fibrinogen, factors V and VIII, which are crucial in maintaining proper blood clotting function. Whole blood (Choice A) is not typically used to correct coagulopathy and is more suitable for situations requiring both volume and oxygen-carrying capacity. Platelets (Choice B) are indicated for thrombocytopenia, not for correcting coagulation factors. Packed red blood cells (Choice D) are used to increase oxygen-carrying capacity in cases of anemia, not for correcting coagulopathy.

3. Which statement is true about food and drug precautions?

• A. Limiting certain types of food or administering certain types of drugs is necessary.
• B. Certain combinations of food and drugs can cause adverse reactions.
• C. Precautions may involve limiting certain types of food or administering drugs rather than restricting the drug itself.
• D. When one drug alters the way another drug affects the body.

Correct answer: B

Rationale: The correct answer is B. Certain combinations of food and drugs can indeed lead to adverse reactions. It is important to be cautious with the simultaneous intake of food and drugs as interactions between them can affect their efficacy and safety. Choices A, C, and D are incorrect because they do not accurately reflect the potential risks associated with the combination of food and drugs.

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

• A. Take this medication at bedtime.
• B. Take this medication with food.
• C. Take this medication on an empty stomach in the morning.
• D. Take this medication with an antacid.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance its absorption. This timing allows for optimal absorption and effectiveness of the medication. Taking it with food, at bedtime, or with an antacid may interfere with its absorption and reduce its efficacy.

5. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

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