Nursing Elites

1. A client is taking Sucralfate PO for Peptic Ulcer Disease and has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

• A. Take an antacid with the sucralfate.
• B. Take sucralfate with a glass of milk.
• C. Allow a 2-hour interval between these medications.
• D. Chew the sucralfate thoroughly before swallowing.

Correct answer: C

Rationale: Sucralfate can interfere with the absorption of phenytoin. To prevent this interaction, the client should allow a 2-hour interval between taking sucralfate and phenytoin. This timing helps to ensure adequate absorption and effectiveness of both medications without compromising therapeutic outcomes. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, and chewing sucralfate thoroughly before swallowing do not address the need for a 2-hour interval between these medications to prevent interference with phenytoin absorption.

2. When educating a client who has a new prescription for Levothyroxine to treat hypothyroidism, which of the following instructions should be included?

• A. Take the medication first thing in the morning before eating.
• B. Take the medication at bedtime to avoid drowsiness.
• C. Take the medication with food to prevent nausea.
• D. Take the medication with a glass of milk.

Correct answer: A

Rationale: Levothyroxine should be taken first thing in the morning before eating to ensure optimal absorption. Taking it on an empty stomach helps prevent interactions with food or other medications that may decrease its effectiveness. It is important to follow this timing recommendation to maintain consistent thyroid hormone levels in the body. Choice B is incorrect as taking Levothyroxine at bedtime may lead to inconsistent absorption and affect its efficacy. Choice C is incorrect because taking Levothyroxine with food can interfere with its absorption. Choice D is incorrect as Levothyroxine should be taken with a full glass of water, not milk, to aid in proper absorption.

3. 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.

4. A client is taking Desmopressin for Diabetes Insipidus. For which of the following adverse effects should the nurse monitor?

• A. Hypovolemia
• B. Hypercalcemia
• C. Agitation
• D. Headache

Correct answer: D

Rationale: Headache is an adverse effect that the nurse should monitor for in a client taking Desmopressin for Diabetes Insipidus. It can be an early sign of water intoxication, which is a potential complication of desmopressin therapy due to excessive water retention in the body.

5. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and osteoporosis are conditions where estrogen therapy may actually be indicated. Dysfunctional uterine bleeding is another condition where estrogen therapy can be used to help regulate menstrual bleeding.

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