Nursing Elites

1. A client is receiving sulfisoxazole. Which of the following should be included in the list of instructions?

• A. Restrict fluid intake.
• B. Maintain a high fluid intake.
• C. If the urine turns dark brown, call the healthcare provider (HCP) immediately.
• D. Decrease the dosage when symptoms are improving to prevent an allergic response.

Correct answer: B

Rationale: When a client is taking sulfisoxazole, it is important to maintain a high fluid intake. Each dose of sulfisoxazole should be taken with a full glass of water, as the medication is more soluble in alkaline urine. Restricting fluid intake is not recommended as it can lead to inadequate hydration. Dark brown urine may be a side effect of some forms of sulfisoxazole but does not necessarily warrant immediate notification of the healthcare provider unless accompanied by other concerning symptoms. Decreasing the dosage when symptoms improve is not advised as it may lead to treatment failure or the development of resistance.

2. A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?

• A. Check the medication order for accuracy.
• B. Have an epinephrine injection available.
• C. Administer a test dose to check for a reaction.
• D. Ask the client about any allergies.

Correct answer: B

Rationale: When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.

3. Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:

• A. 1 hour after each meal
• B. Once daily, at the same time each day
• C. 15 minutes before breakfast, lunch, and dinner
• D. Before each meal, based on the blood glucose level

Correct answer: B

Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.

4. A healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?

• A. Pancreatitis
• B. Pharyngitis
• C. Tonic-clonic seizures
• D. Human immunodeficiency virus (HIV) infection

Correct answer: D

Rationale: Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.

5. A healthcare professional is preparing to administer digoxin (Lanoxin), 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the healthcare professional to check before administering the medication?

• A. Heart rate
• B. Temperature
• C. Respirations
• D. Blood pressure

Correct answer: A

Rationale: Before administering digoxin, it is essential to assess the client's heart rate as this medication directly affects cardiac function. Monitoring the heart rate helps identify if it is within the acceptable range for administering digoxin. A pulse rate below 60 beats per minute warrants withholding the medication to prevent potential adverse effects like bradycardia or cardiac arrhythmias.

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