Nursing Elites

1. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

2. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

3. A client has a new prescription for Valsartan, and a nurse is providing discharge teaching. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid potassium-rich foods.
• C. Expect to feel drowsy.
• D. Monitor your blood pressure daily.

Correct answer: D

Rationale: Monitoring blood pressure daily is crucial for clients taking Valsartan, an angiotensin II receptor blocker, to ensure effective management of hypertension. Valsartan helps lower blood pressure by relaxing blood vessels, and regular monitoring helps track the medication's effectiveness and any potential side effects. Choices A, B, and C are incorrect because Valsartan does not need to be taken with food, avoiding potassium-rich foods is not specifically required for this medication, and feeling drowsy is not a common side effect of Valsartan.

4. A client has a new prescription for combination oral NRTIs for the treatment of HIV. Which of the following statements should the nurse include in discharge teaching?

• A. These medications work by inhibiting enzymes to prevent HIV replication.
• B. These medications work by preventing protein synthesis within the HIV cell.
• C. These medications work by weakening the cell wall of the HIV virus.
• D. These medications work by blocking HIV entry into cells.

Correct answer: A

Rationale: The correct answer is A. NRTI antiretroviral medications inhibit the enzyme reverse transcriptase, which is essential for HIV replication. By blocking this enzyme, the medications prevent the virus from replicating and spreading. This mechanism of action helps to control the progression of HIV infection in the body. Choices B, C, and D are incorrect because NRTIs do not work by preventing protein synthesis, weakening the cell wall of the virus, or blocking HIV entry into cells. These mechanisms are associated with different classes of antiretroviral medications used in HIV treatment.

5. A client is being discharged with a new prescription for Metronidazole. Which of the following instructions should the nurse include?

• A. Avoid drinking alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Avoid dairy products while taking this medication.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Consuming alcohol with Metronidazole can lead to a disulfiram-like reaction, causing symptoms such as nausea, vomiting, and flushing. It is crucial to advise clients to abstain from alcohol during the course of treatment to prevent adverse reactions and ensure the effectiveness of the medication.

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