Nursing Elites

1. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?

• A. Vitamin K1
• B. Protamine
• C. Omeprazole
• D. Probenecid

Correct answer: C

Rationale: Omeprazole or another proton pump inhibitor is commonly prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help alleviate these symptoms by reducing gastric acid secretion, which can contribute to gastrointestinal discomfort. Vitamin K1 is not indicated for adverse effects of dabigatran. Protamine is used to reverse the anticoagulant effects of heparin, not dabigatran. Probenecid is not typically used to treat adverse effects of dabigatran.

2. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. It is essential to alternate nostrils daily when inhaling the medication to ensure equal distribution and optimal absorption. This technique helps prevent irritation and congestion in one nostril and enhances the effectiveness of the medication. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed, applied topically, or taken as a liquid medication after meals. Therefore, instructing the client to alternate nostrils during inhalation is the most appropriate teaching for this medication.

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

• A. Drink 2 liters of water daily.
• B. Avoid taking the medication on an empty stomach.
• C. Limit vitamin C intake while taking this medication.
• D. Take an iron supplement while on this medication.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol is to drink 2 liters of water daily. This recommendation aims to reduce the risk of kidney stones, a potential side effect associated with allopurinol use. Adequate hydration helps prevent the formation of uric acid crystals in the kidneys, which can lead to kidney stones. Therefore, encouraging increased water intake is essential in the management of clients taking allopurinol.

4. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of a transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously. Injection-site redness and swelling are common adverse effects. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for any potential issues or reactions.

5. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

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