Nursing Elites

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

• A. Avoid consuming foods high in vitamin K.
• B. Monitor your blood pressure regularly.
• C. Increase your intake of green, leafy vegetables.
• D. Take the medication with a high-fat meal.

Correct answer: A

Rationale: The correct answer is to advise the client to avoid consuming foods high in vitamin K. Warfarin's effectiveness can be affected by vitamin K intake. Clients should maintain a consistent intake of vitamin K and avoid sudden increases in foods high in vitamin K to ensure the medication works properly and consistently. Choices B, C, and D are incorrect. Monitoring blood pressure, increasing intake of green, leafy vegetables, or taking the medication with a high-fat meal are not specific instructions related to Warfarin therapy.

2. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.

3. A client has a prescription for Amoxicillin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Avoid taking the medication with milk.
• C. Expect your stools to turn clay-colored.
• D. Complete the entire course of therapy.

Correct answer: D

Rationale: The correct answer is D: Complete the entire course of therapy. It is crucial for clients to complete the entire course of amoxicillin therapy to ensure the infection is fully treated and to prevent antibiotic resistance. Prematurely stopping the antibiotic can lead to incomplete eradication of the infection, potentially causing it to return and be more difficult to treat. Choices A and B are not specific to amoxicillin and are general medication administration instructions. Choice C is not a common side effect of amoxicillin and does not require patient education.

4. A client is starting therapy with rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The nurse should instruct the client to report fever when starting rituximab therapy. Fever can be a sign of infection, which is a potential complication associated with rituximab. Early detection and treatment of infections are important to ensure the client's safety and well-being. Dizziness, urinary frequency, and dry mouth are not commonly associated with rituximab therapy and are less likely to be directly related to the medication's side effects. Therefore, fever is the most crucial symptom to report to healthcare providers.

5. A client has a new prescription for Alteplase. Which of the following actions should the nurse plan to take?

• A. Administer the medication within 4 hours of the onset of symptoms.
• B. Reconstitute the medication with sterile saline.
• C. Administer heparin concurrently with the Alteplase infusion.
• D. Monitor for changes in level of consciousness.

Correct answer: D

Rationale: Alteplase is a thrombolytic agent used to dissolve blood clots. Patients receiving Alteplase are at risk for bleeding complications, including intracranial bleeding. Monitoring for changes in the level of consciousness is crucial as it can indicate early signs of bleeding, such as increased intracranial pressure. This rapid assessment allows for timely intervention and prevention of further complications. Choices A, B, and C are incorrect. Administering Alteplase within 4 hours of symptom onset is related to the time-sensitive nature of thrombolytic therapy for conditions like acute myocardial infarction or ischemic stroke. Reconstituting Alteplase with sterile saline is a correct step in preparing the medication for administration. Administering heparin concurrently with Alteplase is generally avoided due to the increased risk of bleeding.

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