Nursing Elites

1. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: When taking colesevelam, it should be administered with food and at least 8 oz of water to ensure proper absorption and reduce the risk of gastrointestinal side effects. Taking colesevelam with food also helps in binding to bile acids efficiently. Options A, B, and C are incorrect because they do not provide the necessary instruction for taking colesevelam correctly or monitoring specific side effects associated with this medication.

2. A client has a new prescription for transdermal patches. Which statement should the client make to indicate understanding of the instructions?

• A. I will clean the site with an alcohol swab before applying the patch.
• B. I will rotate the application sites weekly.
• C. I will apply the patch to an area of skin with no hair.
• D. I will place the new patch on the site of the old patch.

Correct answer: C

Rationale: The correct answer is C. Applying the patch to a hairless area of skin is essential for optimal medication absorption. Hair can interfere with the patch's adherence and effectiveness. It is important for the client to choose a site without hair to ensure proper delivery of the medication. Choices A, B, and D are incorrect because cleaning the site with an alcohol swab (Choice A) is a good practice but not the most crucial aspect for transdermal patch application. Rotating application sites weekly (Choice B) is more relevant for injections to prevent skin irritation or breakdown. Placing the new patch on the site of the old patch (Choice D) can lead to skin irritation and poor absorption due to a build-up of medication.

3. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. To ensure optimal absorption, the client should alternate nostrils daily when inhaling the medication. This practice helps prevent irritation and promotes consistent drug delivery through both nostrils. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed as a tablet, applied topically, or mixed with juice; it is usually administered intranasally.

4. A client has a prescription for gentamicin for the treatment of an infection. Which finding indicates a potential adverse reaction to the medication?

• A. Blood pressure 160/90 mm Hg
• B. Presence of red blood cells in the urine
• C. Urine output of 35 mL/hr
• D. Respiratory rate of 22/min

Correct answer: B

Rationale: The presence of red blood cells in the urine can indicate nephrotoxicity, which is a potential adverse effect of gentamicin. Gentamicin can cause damage to the kidneys, leading to the presence of red blood cells in the urine as a sign of renal impairment. Monitoring for this finding is crucial to detect and manage adverse reactions promptly. High blood pressure (Choice A) is not typically associated with gentamicin use. Low urine output (Choice C) is more suggestive of kidney injury rather than nephrotoxicity specifically related to gentamicin. Respiratory rate (Choice D) is not a common indicator of adverse reactions to gentamicin.

5. Which of the following conditions is not typically treated with Hydrochlorothiazide?

• A. CHF
• B. HTN
• C. Nephritis
• D. Hypercalciuria

Correct answer: C

Rationale: Nephritis is not commonly treated with Hydrochlorothiazide. Hydrochlorothiazide is primarily used for managing hypertension (HTN) and congestive heart failure (CHF) by reducing blood pressure and fluid retention. It is not a standard treatment for nephritis, which involves inflammation of the kidneys. Hypercalciuria, characterized by excessive calcium excretion in the urine, is not typically treated with Hydrochlorothiazide either.

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