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. A client is prescribed Omeprazole for managing heartburn. What information should the nurse include in the teaching?

• A. Take this medication at bedtime.
• B. This medication decreases the production of gastric acid.
• C. Take this medication 2 hours after eating.
• D. This medication can cause hyperkalemia.

Correct answer: B

Rationale: The correct answer is B. The nurse should educate the client that Omeprazole works by reducing the production of gastric acid through inhibiting the enzyme responsible for its production. This action helps in managing heartburn and related symptoms effectively. Choice A is incorrect because Omeprazole is usually taken before eating. Choice C is incorrect as Omeprazole is typically taken before a meal. Choice D is unrelated to Omeprazole, as it is not associated with causing hyperkalemia.

3. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following dietary instructions should the nurse include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Vitamin K can interfere with the effectiveness of Warfarin, an anticoagulant medication. Foods high in vitamin K, such as leafy green vegetables, can reduce the medication's anticoagulant effect. Therefore, clients taking Warfarin should be advised to avoid or consume a consistent amount of foods high in vitamin K to maintain the medication's effectiveness. Choices A, C, and D are incorrect because increasing leafy green vegetables, dairy products, or avoiding foods high in iron are not directly related to the interaction with Warfarin.

4. A client asks the nurse how Rituximab works, which the client is receiving to treat Non-Hodgkin's Leukemia. Which of the following should the nurse include?

• A. Blocks hormone receptors
• B. Increases immune response
• C. Binds with specific antigens on tumor cells
• D. Stops DNA replication during cell division

Correct answer: C

Rationale: Rituximab is a monoclonal antibody that binds with specific antigens on B-lymphocytes, leading to the destruction of cancer cells. In the context of Non-Hodgkin's Leukemia, Rituximab targets and destroys cancerous B-lymphocytes, which helps in treating the disease. Choices A, B, and D are incorrect. Rituximab does not block hormone receptors, increase immune response, or stop DNA replication during cell division. The primary mode of action of Rituximab is its binding with specific antigens on tumor cells, specifically B-lymphocytes, to elicit an immune response against cancerous cells.

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

• A. Take this medication with food.
• B. Avoid taking aspirin while on this medication.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: When a client is prescribed Clopidogrel, an antiplatelet medication, the nurse should instruct them to avoid taking aspirin or other NSAIDs. This is because both medications can increase the risk of bleeding when taken together, potentially leading to serious health complications. Therefore, it is crucial for the client to follow this instruction to ensure their safety and well-being while on Clopidogrel. Choices A, C, and D are incorrect because taking Clopidogrel with food, avoiding foods high in potassium, or taking the medication at bedtime are not specific instructions related to the safe use of Clopidogrel and do not address the potential interaction with aspirin, which is essential for the client's well-being.

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