Nursing Elites

1. 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.

2. A client is prescribed alendronate (Fosamax) for the treatment of osteoporosis. Which instruction should the nurse provide to the client?

• A. Take the medication at bedtime.
• B. Take the medication with a full glass of water.
• C. Lie down for 30 minutes after taking the medication.
• D. Take the medication with food to avoid gastrointestinal upset.

Correct answer: B

Rationale: The correct instruction for a client prescribed alendronate (Fosamax) for osteoporosis is to take the medication with a full glass of water first thing in the morning. It should be taken at least 30 minutes before any food, beverage, or other medication. The client should also remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. Taking alendronate at bedtime or with food is not recommended as it may reduce its absorption and effectiveness.

3. 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.

4. A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?

• A. Calcium chloride
• B. Calcium gluconate
• C. Calcitonin (Miacalcin)
• D. Large doses of vitamin D

Correct answer: C

Rationale: The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.

5. Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is instructed to:

• A. Take the medication at bedtime.
• B. Take the medication in the morning with breakfast.
• C. Lie down for 30 minutes after taking the medication.
• D. Take the medication with a full glass of water after rising in the morning.

Correct answer: D

Rationale: Alendronate (Fosamax) should be taken with a full glass of water after rising in the morning to prevent gastrointestinal side effects and increase absorption. Taking the medication with a full glass of water and in an upright position after waking up helps decrease the risk of esophageal irritation and enhances the drug's effectiveness by ensuring proper absorption in the gastrointestinal tract.

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