Nursing Elites

1. When teaching a client about preventing Otitis Externa, which of the following instructions should the nurse include?

• A. Clean the ear with a cotton-tipped swab daily.
• B. Place earplugs in the ears when sleeping at night.
• C. Use a cool water irrigation solution to remove earwax.
• D. Tip the head to the side to remove water from the ears after showering.

Correct answer: D

Rationale: To prevent Otitis Externa, the nurse should instruct the client to tip the head to the side to allow water to drain out after showering or swimming. This helps to prevent moisture buildup in the ear canal, reducing the risk of developing Otitis Externa, commonly known as swimmer's ear.

2. A client has a new prescription for Furosemide. What instruction should be included by the nurse during discharge?

• A. Take the medication at bedtime.
• B. Increase intake of foods high in potassium.
• C. Avoid sun exposure.
• D. Limit fluid intake.

Correct answer: B

Rationale: The correct answer is to instruct the client to increase intake of foods high in potassium. Furosemide, a loop diuretic, can lead to potassium depletion. Increasing the intake of foods rich in potassium can help prevent hypokalemia, a potential side effect of Furosemide. Choice A is incorrect as Furosemide is usually recommended to be taken in the morning to avoid disrupting sleep with frequent urination. Choice C is irrelevant to the medication. Choice D is also incorrect as Furosemide is a diuretic and may require increased, not limited, fluid intake to prevent dehydration.

3. A client has a prescription for Alendronate. Which of the following instructions should the nurse include?

• A. Take this medication before bed.
• B. Take the medication with food.
• C. Sit upright for at least 30 minutes after taking the medication.
• D. Expect to have frequent headaches while on this medication.

Correct answer: C

Rationale: The correct instruction for a client prescribed Alendronate is to sit upright for at least 30 minutes after taking the medication. Alendronate can cause esophageal irritation, and maintaining an upright position helps prevent this adverse effect by reducing the risk of reflux of the medication into the esophagus. Choice A is incorrect because Alendronate should be taken in the morning, at least 30 minutes before the first food, beverage, or medication of the day with a full glass of plain water. Choice B is incorrect because Alendronate should not be taken with food. Choice D is incorrect because frequent headaches are not a common side effect of Alendronate.

4. What instruction should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine for a client with poison ivy?

• A. Administer the medication with food.
• B. Chew on sugarless gum or suck on hard, sour candies.
• C. Place a humidifier at your bedside every evening.
• D. Discontinue the medication and notify your provider.

Correct answer: B

Rationale: The correct instruction for dry mouth associated with diphenhydramine is to chew on sugarless gum or suck on hard, sour candies. These actions stimulate saliva production, providing relief from dry mouth. Administering the medication with food (Choice A) may help reduce stomach upset but won't address dry mouth. Placing a humidifier at the bedside (Choice C) can help with dry air-related issues but won't specifically target dry mouth. Discontinuing the medication (Choice D) without consulting the provider is not recommended and may lead to inadequate treatment of poison ivy.

5. A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by affecting its metabolism. Echinacea, garlic, and ginseng are also known to interact with Warfarin, either by increasing the risk of bleeding or altering its anticoagulant effects. However, St. John's wort is particularly significant due to its potent enzyme-inducing properties that can lead to subtherapeutic levels of Warfarin, potentially increasing the risk of blood clots.

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