Nursing Elites

1. What is the antidote for Warfarin?

• A. Vitamin D
• B. Vitamin C
• C. Vitamin K
• D. Vitamin B6

Correct answer: C

Rationale: Vitamin K is the antidote for Warfarin toxicity as it helps reverse the anticoagulant effects of Warfarin. Warfarin works by inhibiting vitamin K-dependent clotting factors, and administering vitamin K can replenish these factors, thereby counteracting the anticoagulant effects of Warfarin. Vitamin D, Vitamin C, and Vitamin B6 do not have the specific mechanism to counteract the anticoagulant effects of Warfarin, making them incorrect choices.

2. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)

• A. Expect therapeutic effects in 1-3 weeks.
• B. Discontinue the medication gradually under healthcare provider supervision.
• C. Change positions slowly to minimize dizziness.
• D. Increase dietary fiber intake to prevent constipation.

Correct answer: C

Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.

3. A client has a new prescription for Omeprazole. Which of the following instructions should the nurse include?

• A. Take this medication before meals.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that is most effective in reducing stomach acid production when taken before meals. This timing helps the medication work optimally by inhibiting acid secretion that occurs in response to food intake. Choice B ('Take this medication with food') is incorrect because Omeprazole should be taken before meals. Choice C ('Take this medication at bedtime') is incorrect as the optimal timing is before meals, not at bedtime. Choice D ('Take this medication with antacids') is incorrect because Omeprazole should not be taken with antacids as they can interfere with its absorption.

4. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

5. A client has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?

• A. You should have a high-carbohydrate snack between meals and at bedtime.
• B. You are likely to develop hand tremors if you take this medication for a long period of time.
• C. You may experience temporary numbness of your mouth after each dose.
• D. You should have your white blood cell count monitored every week.

Correct answer: D

Rationale: Clozapine carries a risk for fatal agranulocytosis. To monitor for this serious adverse effect, it is crucial to check the client's white blood cell count weekly while they are on clozapine therapy.

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