Nursing Elites

1. When teaching a client with a new prescription for Warfarin, which herbal supplement should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: The correct answer is St. John's wort. St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism, potentially leading to decreased anticoagulant effects. Therefore, the nurse should instruct the client to avoid using St. John's wort while taking Warfarin to prevent adverse drug interactions. Echinacea, garlic, and ginseng are not the correct answers in this case. While these herbal supplements may also interact with Warfarin and affect its efficacy, St. John's wort has a well-known interaction with Warfarin that can significantly impact its anticoagulant effects. Educating the client about the specific interaction between St. John's wort and Warfarin is crucial to ensure patient safety and the medication's therapeutic benefit.

2. A female client with tobacco use disorder is being educated by a nurse about Nicotine replacement therapy. Which of the following statements by the client shows understanding of the teaching?

• A. I should avoid eating right before I chew a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking if I become pregnant.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. The client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum. Choice B is incorrect because there is no specified timeline for stopping nicotine gum use. Choice C is incorrect because nicotine gum is not recommended during pregnancy. Choice D is incorrect as the client should chew the nicotine gum slowly for about 30 minutes, not quickly for 15 minutes.

3. A client is prescribed Diltiazem. Which of the following findings should the nurse monitor?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperkalemia

Correct answer: B

Rationale: Diltiazem is a calcium channel blocker that can cause bradycardia as an adverse effect due to its negative chronotropic properties, slowing down the heart rate. Therefore, the nurse should monitor the client for signs of bradycardia by regularly assessing the heart rate to prevent potential complications. Monitoring for tachycardia (choice A) is incorrect as diltiazem typically does not cause tachycardia. Hypertension (choice C) is not a typical finding to monitor for with diltiazem use. Hyperkalemia (choice D) is not directly associated with diltiazem administration.

4. A healthcare professional is obtaining a medication history from a client who is to receive Imipenem-cilastatin IV to treat an infection. Which of the following medications the client also receives puts them at risk for a medication interaction?

• A. Regular insulin
• B. Furosemide
• C. Valproic acid
• D. Ferrous sulfate

Correct answer: C

Rationale: The correct answer is C, Valproic acid. Imipenem-cilastatin decreases the blood levels of valproic acid, an antiseizure medication, which can lead to increased seizure activity. Monitoring and adjusting the dosage of valproic acid may be necessary when co-administered with Imipenem-cilastatin to prevent adverse effects. Choices A, B, and D do not typically interact significantly with Imipenem-cilastatin and are not associated with a high risk of adverse interactions in this scenario.

5. What is the therapeutic action of Phenytoin?

• A. Antidiabetic
• B. Anticonvulsant
• C. Mood stabilizer
• D. Antianxiety agent

Correct answer: B

Rationale: Phenytoin is primarily used as an anticonvulsant to prevent and control seizures. It works by stabilizing electrical activity in the brain, making it effective in managing conditions like epilepsy. Antidiabetic medications are used to regulate blood sugar levels, mood stabilizers help manage mood disorders, and antianxiety agents are used to reduce anxiety symptoms, none of which are the primary therapeutic action of Phenytoin.

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