Nursing Elites

1. When teaching a client with a new prescription for warfarin, which statement should the nurse include?

• A. Avoid using a soft toothbrush.
• B. Avoid foods high in vitamin K.
• C. Report any signs of bleeding to your provider.
• D. Use an electric shaver for shaving.

Correct answer: C

Rationale: The correct statement the nurse should include when teaching a client with a new prescription for warfarin is to report any signs of bleeding to their provider. Bleeding can indicate excessive anticoagulation, a potential side effect of warfarin therapy that needs prompt medical attention. Choices A, B, and D are incorrect because while oral hygiene measures, dietary considerations, and skin care are important, they are not the priority when teaching a client about warfarin therapy. Monitoring for and reporting signs of bleeding is crucial due to the anticoagulant effects of warfarin.

2. A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?

• A. A headache indicates a serious allergic reaction to nitroglycerin.
• B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
• C. Nitroglycerin does not cause a headache.
• D. The most common side effect of nitroglycerin is a headache.

Correct answer: D

Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.

3. A patient has been taking hydrocodone, an opioid analgesic for their moderate pain, and they have taken more than the prescribed dose. What should you administer as the antidote if they experience toxicity?

• A. Naloxone
• B. N-acetylcysteine
• C. Atropine
• D. Digoxin immune Fab

Correct answer: A

Rationale: Naloxone is the specific antidote for opioid toxicity. It works by blocking the effects of opioids on the central nervous system, thereby reversing symptoms like respiratory depression and sedation. N-acetylcysteine is used for acetaminophen overdose, while atropine is indicated for certain types of poisonings. Digoxin immune Fab is used for digoxin toxicity. Therefore, in the case of opioid toxicity due to hydrocodone overdose, naloxone is the appropriate antidote.

4. A client with breast cancer is being taught by a nurse about the adverse effects of chemotherapy. Which of the following statements should the nurse include?

• A. You should use a soft-bristled toothbrush to prevent bleeding.
• B. You should avoid contact with individuals who recently received live virus vaccines.
• C. You should take aspirin for minor aches and pains.
• D. You should consume a diet low in protein to reduce the risk of renal damage.

Correct answer: A

Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia. Chemotherapy can decrease platelet counts, leading to an increased risk of bleeding. Using a soft-bristled toothbrush can help prevent gum bleeding and oral trauma. Choices B, C, and D are incorrect. Avoiding contact with individuals who recently received live virus vaccines is crucial to prevent infections in immunocompromised clients. Aspirin should be avoided due to its blood-thinning effects that can increase the risk of bleeding. A diet low in protein is not recommended as cancer clients often require adequate protein intake for healing and recovery.

5. A client has a new prescription for Nifedipine. Which of the following adverse effects should the nurse monitor?

• A. Hypertension
• B. Edema
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Edema. Nifedipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should closely observe the client's lower extremities for any signs of swelling, which could indicate the development of edema. Choice A, Hypertension, is incorrect because Nifedipine is used to treat hypertension, not cause it. Choice C, Hyperglycemia, is unrelated to Nifedipine's common adverse effects. Choice D, Bradycardia, is not typically associated with Nifedipine use.

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