Nursing Elites

1. The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

• A. Intestinal obstruction
• B. Peptic ulcer with melena
• C. Diverticulitis with perforation
• D. Vomiting following cancer chemotherapy

Correct answer: D

Rationale: Metoclopramide, also known as Reglan, is commonly used to manage vomiting following cancer chemotherapy. It acts as a gastrointestinal stimulant and antiemetic, aiding in relieving nausea and vomiting associated with chemotherapy. Metoclopramide should be avoided in conditions like intestinal obstruction, peptic ulcer with melena, and diverticulitis with perforation due to its prokinetic properties that can worsen these conditions. Therefore, the correct answer is D: Vomiting following cancer chemotherapy.

2. A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:

• A. Telling the client not to take the medication with food
• B. Suggesting that the client taper the dose until taste returns to normal
• C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
• D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor

Correct answer: C

Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.

3. A healthcare provider has written a prescription for ranitidine (Zantac), once daily. When should the nurse schedule the medication?

• A. At bedtime
• B. After lunch
• C. With supper
• D. Before breakfast

Correct answer: A

Rationale: The correct answer is A: At bedtime. Ranitidine should be scheduled at bedtime because it provides a prolonged effect and offers the greatest protection of the gastric mucosa. Administering it at this time helps in managing nocturnal acid breakthrough and providing relief during the night.

4. A client with heart failure is prescribed furosemide (Lasix) and digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?

• A. Avoid foods high in potassium.
• B. Report a pulse rate less than 60 beats per minute.
• C. Take the medications in the morning.
• D. Weigh yourself daily.

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to report a pulse rate less than 60 beats per minute, as it could indicate digoxin toxicity. Consuming potassium-rich foods is encouraged due to the potential for furosemide (Lasix) to cause hypokalemia. The medications should be taken in the morning to prevent nocturia. Weighing oneself daily is important to monitor for fluid retention, a crucial aspect in managing heart failure. Therefore, choices A, C, and D are incorrect as they do not address the specific teaching point related to digoxin and its potential toxicity.

5. A client is taking ticlopidine hydrochloride (Ticlid). The nurse tells the client to avoid which of the following while taking this medication?

• A. Vitamin C
• B. Vitamin D
• C. Acetaminophen (Tylenol)
• D. Acetylsalicylic acid (aspirin)

Correct answer: D

Rationale: Ticlopidine hydrochloride is a platelet aggregation inhibitor. Aspirin or any aspirin-containing product should be avoided as they can precipitate or aggravate bleeding by affecting platelet function and increasing the risk of bleeding complications.

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