Nursing Elites

1. A client has a new prescription for Docusate Sodium. Which of the following instructions should the nurse include?

• A. Take the medication with a full glass of water.
• B. Expect results within 30 minutes.
• C. Take this medication at bedtime.
• D. Avoid taking this medication with food.

Correct answer: A

Rationale: The correct instruction for a client prescribed Docusate Sodium is to take the medication with a full glass of water. Docusate sodium is a stool softener, and taking it with water helps to soften the stool and make bowel movements easier. Adequate fluid intake is crucial when taking stool softeners to prevent constipation. Choices B, C, and D are incorrect. B is incorrect because the effects of Docusate Sodium may not be immediate, and it may take a couple of days for the stool softener to work. Choice C is incorrect as there is no specific requirement to take this medication at bedtime. Choice D is incorrect because there is no instruction to avoid taking Docusate Sodium with food.

2. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

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

• A. Take this medication at bedtime.
• B. Monitor for signs of hyperglycemia.
• C. Avoid drinking grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct instruction for a client prescribed Verapamil is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication. This can result in a higher risk of adverse effects, such as hypotension and bradycardia. Therefore, it is essential for the client to avoid grapefruit juice while taking Verapamil to prevent potential complications. Choices A, B, and D are incorrect because taking Verapamil at bedtime, monitoring for signs of hyperglycemia, and increasing potassium-rich foods intake are not specific instructions related to Verapamil therapy and do not address the potential interaction with grapefruit juice.

4. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients experiencing tachycardia, including those with reflex tachycardia induced by medications like Isosorbide Mononitrate. Furosemide (Choice A) is a diuretic and is not indicated for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor used for hypertension and heart failure, not tachycardia. Ranolazine (Choice C) is used in chronic angina but does not address tachycardia.

5. When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Expect the development of a mild rash.
• B. Take the medication on an empty stomach.
• C. Monitor for signs of gingival hyperplasia.
• D. Increase your intake of calcium.

Correct answer: C

Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.

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