Nursing Elites

1. A client has a new prescription for Ranitidine to treat peptic ulcer disease. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid smoking while taking this medication.
• C. Increase intake of dairy products.
• D. Expect a yellow tinge to the skin.

Correct answer: B

Rationale: The correct instruction that the nurse should include for a client prescribed Ranitidine to treat peptic ulcer disease is to avoid smoking while taking the medication. Smoking can interfere with the effectiveness of ranitidine and worsen ulcer symptoms. Therefore, it is crucial for clients to abstain from smoking to ensure optimal therapeutic outcomes. Choices A, C, and D are incorrect. Taking Ranitidine with or without food does not significantly affect its effectiveness, there is no specific need to increase intake of dairy products, and expecting a yellow tinge to the skin is not a common side effect associated with Ranitidine.

2. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.

3. A healthcare provider is reviewing the health history of a client who has a prescription for Propranolol. Which of the following findings should the provider report?

• A. Previous history of thromboembolism
• B. Concurrent use of an antacid
• C. History of bronchial asthma
• D. Recent weight gain

Correct answer: C

Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with a history of bronchial asthma. Reporting a history of bronchial asthma to the provider is crucial as it would prompt a review of the medication prescription to avoid potential adverse effects and consider alternative treatment options.

4. A client has a new prescription for Levofloxacin. Which of the following instructions should be included in the discharge instructions?

• A. Take this medication with food.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking this medication with dairy products.' Levofloxacin should not be taken with dairy products because calcium can interfere with the absorption of the medication. It is recommended to take Levofloxacin 1 hour before or 2 hours after consuming dairy products to ensure optimal absorption and effectiveness of the medication. Choices A, C, and D are incorrect. Choice A is not recommended as Levofloxacin is usually taken on an empty stomach. Choice C is not necessary information for taking Levofloxacin. Choice D is unrelated to the administration of Levofloxacin.

5. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.

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