Nursing Elites

1. A client has been prescribed cyclosporine (Sandimmune). Which food item should the client avoid based on the medication's interaction?

• A. Red meats
• B. Orange juice
• C. Grapefruit juice
• D. Green, leafy vegetables

Correct answer: C

Rationale: Grapefruit juice should be avoided when taking cyclosporine because it inhibits the metabolism of the medication, leading to increased blood levels and a higher risk of toxicity. It is important for the client to follow this dietary instruction to ensure the safe and effective use of cyclosporine.

2. The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medication for which times?

• A. With meals and at bedtime
• B. Every 6 hours around the clock
• C. One hour after meals and at bedtime
• D. One hour before meals and at bedtime

Correct answer: D

Rationale: Sucralfate is a gastric protectant that forms a protective coating over the ulcer. Administering sucralfate 1 hour before meals and at bedtime is important to create a barrier that protects the ulcer from gastric acid and mechanical irritation. This timing allows sucralfate to effectively coat the ulcer site and provide the desired therapeutic effect, enhancing its efficacy in promoting ulcer healing and symptom relief.

3. When providing instructions to a client taking ciprofloxacin (Cipro), which of the following should the nurse include in the teaching plan?

• A. Avoid taking the medication with milk or antacids.
• B. Take the medication with a multivitamin.
• C. Consume extra dairy products while taking this medication.
• D. Take the medication with food if gastrointestinal upset occurs.

Correct answer: A

Rationale: The correct answer is to avoid taking ciprofloxacin (Cipro) with milk or antacids. These can interfere with the medication's absorption. Consuming extra dairy products or taking it with a multivitamin is not recommended for the same reason. If gastrointestinal upset occurs, the medication can be taken with food to help alleviate the symptoms.

4. A client with severe acne is seen in the clinic, and the healthcare provider prescribes isotretinoin. The nurse reviews the client's medication record and would contact the healthcare provider if the client is taking which medication?

• A. Vitamin A
• B. Digoxin (Lanoxin)
• C. Furosemide (Lasix)
• D. Phenytoin (Dilantin)

Correct answer: A

Rationale: Isotretinoin is a metabolite of vitamin A, which can lead to toxicity when taken together. Therefore, it is crucial to avoid concurrent use of vitamin A supplements with isotretinoin. Contacting the healthcare provider to discuss discontinuing vitamin A supplements is important to prevent potential adverse effects. Choices B, C, and D are incorrect as they are not known to interact significantly with isotretinoin.

5. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

• A. Fever
• B. Diarrhea
• C. Complaints of nausea and vomiting
• D. Crackles on auscultation of the lungs

Correct answer: D

Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.

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