Nursing Elites

1. A client is being taught about taking Tetracycline to treat a GI infection caused by Helicobacter pylori. Which of the following statements should indicate to the nurse that the client understands the instructions?

• A. I will take this medication with 8 ounces of milk.
• B. I will inform my doctor if I experience diarrhea.
• C. I can discontinue this medication when I feel completely well.
• D. I can take this medication just before bedtime.

Correct answer: B

Rationale: The correct answer is B. Diarrhea can indicate the development of a suprainfection, which can be serious. Therefore, it is essential for the client to notify the healthcare provider if they experience diarrhea while taking Tetracycline to treat a GI infection caused by Helicobacter pylori. Choices A, C, and D are incorrect because taking Tetracycline with milk can reduce its absorption, discontinuing the medication prematurely can lead to treatment failure, and taking it just before bedtime may increase the risk of esophageal irritation due to the potential reflux of the medication.

2. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist, such as albuterol, and an inhaled glucocorticoid, such as beclomethasone, for asthma control, the beta2-agonist should be administered first. This sequence is important because the beta2-agonist promotes bronchodilation, which enhances the absorption and effectiveness of the glucocorticoid. Instructing the client to administer the albuterol inhaler before using the beclomethasone inhaler ensures optimal therapeutic benefit. Therefore, option B is the correct choice. Option A is incorrect because the timing of albuterol administration may vary based on the prescribed regimen. Option C is incorrect because beclomethasone is a controller medication, not a rescue medication, and should not be used during acute episodes. Option D is incorrect because beclomethasone should be shaken before use to ensure proper dispersion of the medication.

3. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

4. A client is starting therapy with cisplatin. The healthcare provider should instruct the client to report which of the following adverse effects?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is tinnitus. Cisplatin can cause ototoxicity, which may manifest as tinnitus. Tinnitus should be reported promptly to the healthcare provider to prevent further hearing damage.

5. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?

• A. Bony orbit
• B. Nasolacrimal duct
• C. Conjunctival sac
• D. Outer canthus

Correct answer: B

Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.

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