Nursing Elites

1. A patient is being discharged with a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bedtime.
• B. Monitor for increased blood pressure.
• C. Take the medication with food.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct instruction the nurse should include is to monitor for leg cramps. Leg cramps can be a sign of hypokalemia, which is a potential adverse effect of Hydrochlorothiazide. By monitoring for leg cramps, the patient can detect signs of low potassium levels and report them to the healthcare provider promptly. This proactive approach helps prevent complications associated with hypokalemia. The other options are incorrect because taking Hydrochlorothiazide before bedtime or with food is not specific to the medication's adverse effects. Monitoring for increased blood pressure is not typically a common adverse effect of this medication.

2. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.

3. Which drug is the antidote for Alprazolam?

• A. Physostigmine
• B. Protamine sulfate
• C. Flumazenil
• D. Acetylcysteine

Correct answer: C

Rationale: Flumazenil is the specific antidote used to reverse the effects of Alprazolam. Alprazolam is a benzodiazepine, and Flumazenil is a benzodiazepine receptor antagonist that works by competitively inhibiting the actions of benzodiazepines at the receptor site, effectively reversing their sedative and other effects. Physostigmine is not used as an antidote for benzodiazepine overdose and can have significant side effects. Protamine sulfate is used to reverse the effects of heparin, not benzodiazepines like Alprazolam. Acetylcysteine is used as an antidote for acetaminophen overdose, not benzodiazepines like Alprazolam.

4. What is the action of Metformin?

• A. Decreasing intestinal glucose absorption
• B. Increasing sensitivity to insulin
• C. Decreasing hepatic glucose production
• D. All of the above

Correct answer: D

Rationale: Metformin exerts its effects by decreasing hepatic glucose production, increasing sensitivity to insulin, and decreasing intestinal glucose absorption. These actions help in lowering blood glucose levels and improving insulin sensitivity in individuals with diabetes.

5. When teaching the family of a child with Cystic Fibrosis about a new prescription for Acetylcysteine, which information should the nurse include?

• A. Expect this medication to suppress your cough.
• B. Expect this medication to smell like rotten eggs.
• C. Expect this medication to cause euphoria.
• D. Expect this medication to turn your urine orange.

Correct answer: B

Rationale: The correct answer is B: 'Expect this medication to smell like rotten eggs.' Acetylcysteine contains sulfur, which gives it a characteristic rotten-egg odor. This odor is normal and expected when using this medication. Choices A, C, and D are incorrect because Acetylcysteine is not used to suppress cough, cause euphoria, or change urine color. Educating the family on the distinct smell of Acetylcysteine will help them understand its characteristics and alleviate concerns about the odor.

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