Nursing Elites

1. Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?

• A. To take the medication after meals
• B. To return to the clinic weekly for serum drug-level testing
• C. To call the health care provider (HCP) if a skin rash occurs
• D. To restrict alcohol intake with this medication

Correct answer: B

Rationale: Cycloserine requires weekly serum drug level determinations to monitor for neurotoxicity. The medication must be taken after meals, and the client should avoid alcohol. Additionally, the client should report any signs of skin rash or central nervous system toxicity to the healthcare provider.

2. Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection following an allogeneic renal transplant. Which of the following instructions does the nurse reinforce regarding administration of this medication?

• A. Administer on an empty stomach.
• B. Take the medication with a calcium-type antacid.
• C. Open the capsule and mix with food for administration.
• D. Contact the health care provider (HCP) if a sore throat occurs.

Correct answer: D

Rationale: The correct instruction for administering mycophenolate mofetil (CellCept) is to contact the healthcare provider (HCP) if unusual bleeding or bruising, sore throat, or other adverse effects occur. It is essential not to open or crush the capsules to maintain the medication's efficacy.

3. A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?

• A. Take the medication with a full glass of water.
• B. Increase your intake of purine-rich foods.
• C. Stop taking the medication if you experience a gout attack.
• D. Take the medication with or without food.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.

4. A client is being taught about the use of enoxaparin (Lovenox) for the prevention of deep vein thrombosis. Which instruction should the nurse include in the teaching plan?

• A. Inject the medication subcutaneously.
• B. Avoid massaging the injection site after administration.
• C. Administer the medication at the same time each day.
• D. Do not expel the air bubble from the syringe before injection.

Correct answer: C

Rationale: Enoxaparin (Lovenox) is administered subcutaneously at the same time each day to maintain consistent blood levels. Injecting the medication into the muscle is incorrect, as it should be given subcutaneously. Massaging the injection site should be avoided to prevent bruising. The air bubble in the prefilled syringe should not be expelled, as it ensures the full dose is administered.

5. While taking trimethoprim-sulfamethoxazole (TMP-SMZ), a client should be instructed to report which symptom if it develops during the course of this medication therapy?

• A. Nausea
• B. Diarrhea
• C. Headache
• D. Sore throat

Correct answer: D

Rationale: Clients prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) should be educated about potential blood disorders associated with the medication. Early signs of these disorders include symptoms like sore throat, fever, and pallor. If the client experiences any of these symptoms, they should promptly notify their healthcare provider. Nausea, diarrhea, and headache are common side effects of TMP-SMZ that usually do not require immediate medical attention.

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