Nursing Elites

1. A client is prescribed an IM dose of penicillin. She reports developing a rash after taking penicillin 3 years ago. What action should the healthcare professional take?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. It is crucial to report any past allergic reactions to medications, as this information guides the provider in prescribing a safe alternative. Administering the prescribed dose without considering the client's history of developing a rash can lead to potentially severe adverse reactions. Changing the prescription to an oral form or administering an oral antihistamine does not address the risk of an allergic reaction to penicillin in this case.

2. Which of the following is the primary site of activity for the drug Warfarin?

• A. Kidney
• B. Liver
• C. Blood
• D. Heart

Correct answer: B

Rationale: Warfarin primarily affects the liver where it inhibits the synthesis of clotting factors.

3. What is the antidote for Warfarin?

• A. Vitamin D
• B. Vitamin C
• C. Vitamin K
• D. Vitamin B6

Correct answer: C

Rationale: Vitamin K is the antidote for Warfarin toxicity as it helps reverse the anticoagulant effects of Warfarin. Warfarin works by inhibiting vitamin K-dependent clotting factors, and administering vitamin K can replenish these factors, thereby counteracting the anticoagulant effects of Warfarin. Vitamin D, Vitamin C, and Vitamin B6 do not have the specific mechanism to counteract the anticoagulant effects of Warfarin, making them incorrect choices.

4. When teaching a client with a new prescription for furosemide, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for furosemide, a diuretic, is to take it in the morning to prevent nocturia. Taking it in the morning helps to prevent frequent urination during the night, allowing the client to have uninterrupted sleep. This timing also coincides with the body's natural diuretic response, which is typically more active during the day. Choices B, C, and D are incorrect because furosemide does not require avoiding foods high in potassium, taking it on an empty stomach, or limiting fluid intake to 1 liter per day.

5. A client has been prescribed an ACE Inhibitor for hypertension. Which of the following instructions should be included by the healthcare provider?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Avoid foods high in potassium.
• D. Limit your fluid intake.

Correct answer: A

Rationale: The correct answer is to 'Avoid salt substitutes.' ACE Inhibitors can increase potassium levels, so clients should avoid salt substitutes that contain potassium to prevent hyperkalemia, which is a potential side effect of ACE Inhibitors. Choice B 'Take this medication at bedtime' is incorrect as ACE Inhibitors are usually taken in the morning to avoid nocturnal diuresis. Choice C 'Avoid foods high in potassium' is incorrect because although ACE Inhibitors can increase potassium levels, clients are generally encouraged to consume potassium-rich foods in moderation unless contraindicated. Choice D 'Limit your fluid intake' is also incorrect as ACE Inhibitors do not typically require fluid restrictions unless specified by a healthcare provider for other reasons.

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