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. A client with asthma has a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?

• A. Check the pulse after using the inhaler.
• B. Take the medication with food.
• C. Rinse the mouth after using the inhaler.
• D. Reduce caffeine consumption.

Correct answer: C

Rationale: The correct answer is C: 'Rinse the mouth after using the inhaler.' Rinsing the mouth after using inhaled beclomethasone is crucial to prevent fungal overgrowth in the mouth, a common side effect of corticosteroid inhalers. Checking the pulse after using the inhaler (Choice A) is not directly related to the use of beclomethasone. Taking the medication with food (Choice B) is not a specific instruction for inhaled beclomethasone. While reducing caffeine consumption (Choice D) can be beneficial for some health conditions, it is not a specific instruction related to using inhaled beclomethasone.

3. A client is starting therapy with cisplatin, and a healthcare provider is providing education. Which of the following findings should the healthcare provider instruct the client to report?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Tinnitus. The healthcare provider should instruct the client to report tinnitus, as it can be an indication of ototoxicity, an adverse effect associated with cisplatin therapy. Ototoxicity is damage to the inner ear structures that can lead to hearing loss, making it crucial for the client to report any early signs such as tinnitus to prevent further complications. Choices B, C, and D are less concerning in the context of cisplatin therapy. Nausea and constipation are common side effects of cisplatin but are not typically indicative of serious complications requiring immediate reporting. Weight gain is not a typical side effect associated with cisplatin therapy and is less likely to be related to the medication.

4. A client has a new prescription for Atenolol. Which of the following statements should be included by the healthcare provider?

• A. Take the medication with a high-fat meal.
• B. Monitor your heart rate before taking the medication.
• C. Expect a persistent cough.
• D. Avoid foods high in fiber.

Correct answer: B

Rationale: When a client is prescribed Atenolol, a beta-blocker, they should monitor their heart rate before taking the medication. It is crucial because if the heart rate is below 60 bpm, the client needs to contact their healthcare provider for further guidance and evaluation. Choices A, C, and D are incorrect. Atenolol does not need to be taken with a high-fat meal, does not typically cause a persistent cough, and there is no need to avoid foods high in fiber when taking this medication.

5. Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?

• A. Antiplatelets
• B. Beta-adrenergic blockers
• C. ACE inhibitors
• D. Calcium channel blockers

Correct answer: B

Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.

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