Nursing Elites

1. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.

2. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

3. When teaching a client with a new prescription for Clopidogrel, which laboratory value should the nurse monitor to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication that works by reducing the formation of blood clots. Therefore, the nurse should monitor the client's platelet count to assess for potential bleeding complications. A decrease in platelet count could indicate a risk of bleeding, which is an adverse effect associated with Clopidogrel therapy. Monitoring other laboratory values like white blood cell count, hemoglobin, and blood glucose is important for assessing overall health status but is not directly related to the potential adverse effects of Clopidogrel.

4. A healthcare professional is preparing to administer an IV antibiotic to a client who has a systemic infection. Which of the following actions should the professional take first?

• A. Administer an antihistamine prior to the antibiotic.
• B. Monitor the client's urine output.
• C. Check the client's allergy history.
• D. Assess the client's vital signs.

Correct answer: C

Rationale: The first action the healthcare professional should take is to check the client's allergy history before administering the antibiotic to prevent a potential allergic reaction. It is crucial to identify any known allergies to antibiotics to ensure the client's safety and well-being. Administering an antihistamine prior to the antibiotic (Choice A) is not recommended unless an allergic reaction occurs. Monitoring the client's urine output (Choice B) and assessing the client's vital signs (Choice D) are important but not the first step in this situation. Checking the client's allergy history takes precedence to prevent adverse reactions.

5. A client is being discharged with a new prescription for an antihypertensive medication. Which of the following statements should the nurse provide?

• A. Be sure to limit your potassium intake while taking the medication.
• B. You should check your blood pressure every 8 hours while taking this medication.
• C. Your medication dosage will be increased if you develop tachycardia.
• D. Change positions slowly when you move from sitting to standing.

Correct answer: D

Rationale: The correct answer is D. Orthostatic hypotension is a common adverse effect of antihypertensive medications. The client should move slowly to a sitting or standing position and should be taught to sit or lie down if lightheadedness or dizziness occurs. Choices A, B, and C are incorrect. Limiting potassium intake is usually not necessary with antihypertensive medications. Checking blood pressure every 8 hours is not a standard recommendation unless specified by a healthcare provider. Increasing medication dosage due to tachycardia is not a typical practice for antihypertensive medications.

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