Nursing Elites

1. When a client is receiving treatment with methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Vitamin D
• C. Calcium
• D. Iron

Correct answer: A

Rationale: Folic acid supplementation is crucial for clients undergoing methotrexate treatment because methotrexate functions as a folic acid antagonist. By supplementing with folic acid, the risk of methotrexate toxicity can be minimized, improving the treatment's effectiveness and safety. Vitamin D, calcium, and iron are not specifically recommended in conjunction with methotrexate therapy and may not provide the same protective benefits as folic acid.

2. 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. Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking warfarin. Warfarin works by inhibiting the clotting factors dependent on vitamin K, so Vitamin K intake should be consistent but not excessive. Calcium carbonate and ranitidine do not significantly increase the risk of bleeding when used concurrently with Warfarin.

3. A healthcare professional is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The healthcare professional should clarify which of the following parts of the prescription with the provider?

• A. Name
• B. Dosage
• C. Route
• D. Frequency

Correct answer: D

Rationale: The prescription lacks the frequency of medication administration, which is crucial for ensuring appropriate use. In this case, the frequency of when the medication can be taken needs to be clarified with the provider to provide safe and effective care for the client with Hyperemesis Gravidarum.

4. A client asks the nurse to explain the difference between stable and unstable angina. What is the best response by the nurse?

• A. "Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• B. "Unstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• C. "Unstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?
• D. "Stable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest."?

Correct answer: A

Rationale: Stable angina is typically triggered by physical exertion or emotional stress and is predictable in its frequency, intensity, and duration. In contrast, unstable angina is characterized by angina episodes that are unexpected, more severe, prolonged, and can occur at rest. Understanding these differences can help healthcare providers assess and manage angina episodes effectively, ensuring appropriate interventions are implemented promptly based on the type of angina present.

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

• A. Avoid consuming foods high in vitamin K.
• B. Monitor your blood pressure regularly.
• C. Increase your intake of green, leafy vegetables.
• D. Take the medication with a high-fat meal.

Correct answer: A

Rationale: The correct answer is to advise the client to avoid consuming foods high in vitamin K. Warfarin's effectiveness can be affected by vitamin K intake. Clients should maintain a consistent intake of vitamin K and avoid sudden increases in foods high in vitamin K to ensure the medication works properly and consistently. Choices B, C, and D are incorrect. Monitoring blood pressure, increasing intake of green, leafy vegetables, or taking the medication with a high-fat meal are not specific instructions related to Warfarin therapy.

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