Nursing Elites

1. A client with a new prescription for Verapamil to control hypertension is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid drinking grapefruit juice.
• B. I can expect my heart rate to increase while taking this medication.
• C. This medication will cause my urine to turn orange.
• D. I will stop taking this medication if I experience headaches.

Correct answer: A

Rationale: The correct answer is A. Grapefruit juice can increase blood levels of verapamil, leading to increased effects and potentially serious side effects such as hypotension or bradycardia. It is crucial for the client to avoid grapefruit juice while taking Verapamil to prevent these adverse reactions. Choice B is incorrect because verapamil is a calcium channel blocker that typically lowers heart rate. Choice C is incorrect as verapamil does not cause urine discoloration. Choice D is incorrect because stopping medication abruptly without consulting a healthcare provider can be dangerous.

2. A healthcare professional is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the healthcare professional expect to cause an adverse effect when administered concurrently with Fentanyl?

• A. Ampicillin
• B. Diazepam
• C. Furosemide
• D. Prednisone

Correct answer: B

Rationale: Diazepam, a CNS depressant, can interact with Fentanyl causing severe sedation when administered concurrently. This is due to the additive central nervous system depressant effects of both medications, which can lead to excessive sedation, respiratory depression, and other serious adverse effects. Therefore, healthcare professionals need to monitor clients closely for signs of excessive sedation or respiratory depression when administering these medications together.

3. What is the antidote for Heparin?

• A. Protamine sulfate
• B. Narcan
• C. Romazicon
• D. Naloxone

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant medication used to prevent blood clots. In cases of overdose or excessive bleeding due to Heparin, protamine sulfate is administered as the specific antidote. Protamine sulfate works by neutralizing Heparin's anticoagulant activity. Choices B, C, and D are incorrect. Narcan (Naloxone) is used to reverse opioid overdose, Romazicon (Flumazenil) is used to reverse benzodiazepine overdose, and Naloxone is also used to reverse opioid overdose but is not the antidote for Heparin.

4. A healthcare provider is providing teaching to a client who has a new prescription for metronidazole. The healthcare provider should instruct the client to avoid which of the following?

• A. Dairy products
• B. Alcohol
• C. Leafy green vegetables
• D. Grapefruit juice

Correct answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole due to the risk of a disulfiram-like reaction. This reaction can cause symptoms like flushing, headache, nausea, and vomiting when alcohol is consumed while on metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole. Dairy products do not interfere with metronidazole absorption; leafy green vegetables are safe to consume as they do not affect metronidazole metabolism, and grapefruit juice is not contraindicated with metronidazole.

5. In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A). Sodium bicarbonate (Choice B) is not indicated for hypotension related to Verapamil use. Potassium chloride (Choice C) and Magnesium sulfate (Choice D) are not the appropriate medications to address the hypotension in this situation.

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