Nursing Elites

1. A client has a new prescription for Nitrofurantoin. Which of the following instructions should be included?

• A. Take this medication with food.
• B. Avoid dairy products while taking this medication.
• C. Take this medication at bedtime.
• D. Increase your intake of vitamin C.

Correct answer: A

Rationale: Nitrofurantoin should be taken with food to enhance absorption and reduce gastrointestinal side effects. Taking it with a meal or a snack can help minimize stomach upset. Instructing the client to take the medication with food ensures optimal effectiveness and tolerability of the drug. Choice B is incorrect because there is no specific interaction between Nitrofurantoin and dairy products. Choice C is incorrect as there is no requirement to take Nitrofurantoin at bedtime. Choice D is also incorrect as increasing vitamin C intake is not necessary or relevant to taking Nitrofurantoin.

2. A healthcare professional is planning to administer Morphine IV to a postoperative client. Which of the following actions should the healthcare professional take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea that occurs with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action the healthcare professional should take when administering Morphine IV to a postoperative client is to withhold the medication if the respiratory rate is less than 12/min. Respiratory depression is a common adverse effect of opioids like Morphine. Administering opioids when the respiratory rate is already compromised can further depress breathing, leading to life-threatening complications. Monitoring for seizures and confusion (Choice A) is not directly related to Morphine administration. Protecting the client's skin from severe diarrhea (Choice B) is not a common side effect of morphine. Administering Morphine via IV bolus (Choice D) should be done carefully but is not the most critical action in this scenario.

3. Before administering lithium to a client with bipolar disorder who has been taking the medication for 1 year, the nurse should check to see that which of the following tests has been completed?

• A. Thyroid hormone assay
• B. Liver function tests
• C. Erythrocyte sedimentation rate
• D. Brain natriuretic peptide

Correct answer: A

Rationale: The correct answer is to check the thyroid hormone assay. Long-term lithium use can result in thyroid dysfunction, making it crucial to monitor the client's thyroid function regularly to detect any abnormalities early and prevent potential complications. Liver function tests (choice B) are not specifically associated with lithium therapy. Erythrocyte sedimentation rate (choice C) is a nonspecific test for inflammation and not directly related to lithium therapy. Brain natriuretic peptide (choice D) is a test used to diagnose heart failure and is not relevant to monitoring lithium therapy.

4. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

• A. Calcium 9.2 mg/dL
• B. Calcium 10.3 mg/dL
• C. Potassium 3.4 mEq/L
• D. Potassium 4.8 mEq/L

Correct answer: C

Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.

5. A client has a new prescription for Folic Acid. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Expect a metallic taste in your mouth.
• C. Increase your intake of green, leafy vegetables.
• D. Avoid citrus fruits.

Correct answer: C

Rationale: The correct answer is C: 'Increase your intake of green, leafy vegetables.' Folic acid is naturally found in green, leafy vegetables. By increasing the intake of these vegetables, the client can supplement their folic acid levels. This dietary adjustment supports the client in meeting the prescription requirements and enhances the overall health benefits of folic acid. Choices A, B, and D are incorrect because they do not directly relate to increasing folic acid intake as required by the prescription.

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