Nursing Elites

1. A nurse is teaching a client who has breast cancer 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 take aspirin for minor aches and pains.'
• C. You should avoid contact with individuals who recently received live virus vaccines.'
• 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.

2. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

• A. Contact the provider if the heart rate is less than 60/min.
• B. Check the pulse rate for 30 seconds and multiply the result by 2.
• C. Increase the intake of sodium.
• D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.

3. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?

• A. Metformin
• B. Metoprolol
• C. Lisinopril
• D. Insulin

Correct answer: A

Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.

4. A client is reviewing a new prescription for Terbutaline with a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

• A. I can increase my activity now that I've started on this medication.
• B. I will increase my daily fluid intake to 3 quarts.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider as these are signs of preterm labor. Monitoring contractions is crucial for the management of preterm labor and the safety of both the client and the fetus. Choices A, B, and D are incorrect because increasing activity, fluid intake, or assuming the medication will prevent preterm labor do not address the essential need to report changes in contractions, which are a vital sign of potential complications in preterm labor.

5. A client is prescribed Omeprazole for managing heartburn. What information should the nurse include in the teaching?

• A. Take this medication at bedtime.
• B. This medication decreases the production of gastric acid.
• C. Take this medication 2 hours after eating.
• D. This medication can cause hyperkalemia.

Correct answer: B

Rationale: The correct answer is B. The nurse should educate the client that Omeprazole works by reducing the production of gastric acid through inhibiting the enzyme responsible for its production. This action helps in managing heartburn and related symptoms effectively. Choice A is incorrect because Omeprazole is usually taken before eating. Choice C is incorrect as Omeprazole is typically taken before a meal. Choice D is unrelated to Omeprazole, as it is not associated with causing hyperkalemia.

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