Nursing Elites

1. Which of the following drugs is associated with hepatitis as a reaction?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: C

Rationale: Hepatitis is a known side effect of isoniazid. It is important to monitor patients on isoniazid for signs of liver damage, including hepatitis, as part of their treatment regimen for tuberculosis.

2. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

3. When providing teaching to a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a side effect that affects the gums. It is crucial for the client to maintain good oral hygiene to prevent oral health complications. Choices A, B, and D are incorrect. While the timing of medication administration and dietary considerations are important, they are not directly related to preventing the specific side effect of gingival hyperplasia caused by Phenytoin.

4. A client has a new prescription for Amlodipine. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication at bedtime.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of high-sodium foods.
• D. Expect a dry cough.

Correct answer: B

Rationale: The correct instruction for the nurse to include during discharge teaching is to advise the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of amlodipine, a calcium channel blocker, leading to increased drug levels in the blood. This can result in potentiated side effects and potential toxicity. Option A is incorrect as amlodipine is usually taken once daily, not specifically at bedtime. Option C is incorrect because high-sodium foods are generally discouraged in individuals with hypertension. Option D is incorrect as a dry cough is not an expected side effect of amlodipine.

5. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

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