Nursing Elites

1. A client has a new prescription for Alendronate. Which of the following instructions should be included in the discharge teaching?

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. This medication can cause esophageal irritation, and maintaining an upright position for at least 30 minutes helps prevent complications such as esophagitis or esophageal ulcers. Choice A is incorrect because Alendronate should be taken in the morning on an empty stomach. Choice C is incorrect because Alendronate should be taken on an empty stomach, preferably 30 minutes before the first food, beverage, or medication of the day. Choice D is incorrect because while calcium intake is important, it is not a specific instruction related to taking Alendronate.

2. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: The correct answer is C, Regular insulin. Regular insulin, also known as short-acting insulin, typically exhibits a peak effect around 1 to 5 hours following administration. This rapid onset and peak effect make it suitable for managing postprandial glucose levels. Insulin glargine is a long-acting insulin with no pronounced peak effect, making it unsuitable for rapid glucose control within 1 to 5 hours. NPH insulin has an intermediate duration of action and a different peak time frame. Insulin lispro is a rapid-acting insulin that peaks within 30 minutes to 2.5 hours after administration, not within the 1 to 5-hour range.

3. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer subcutaneously in a large muscle mass to prevent injury.
• B. Ensure that the medication is kept at room temperature until just prior to administration.
• C. Invert vial gently to mix well before withdrawing dose.
• D. Discard vial after removing one dose of the medication.

Correct answer: D

Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.

4. A client has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will need to get my blood drawn periodically while on this medication.
• B. I should stop taking this medication if I develop a rash.
• C. I will need to limit my alcohol intake to no more than one drink per week.
• D. I should self-administer this medication subcutaneously.

Correct answer: A

Rationale: The correct answer is A because Etanercept can cause bone marrow suppression, so it is crucial to monitor blood counts regularly to detect any early signs of adverse effects.

5. What should a patient avoid while taking Angiotensin-converting enzymes?

• A. Salt substitutes
• B. Foods high in potassium
• C. Foods high in sodium
• D. All of the above

Correct answer: A

Rationale: Patients taking Angiotensin-converting enzyme (ACE) inhibitors should avoid salt substitutes because they can contain potassium chloride, which may lead to hyperkalemia. It is important to restrict potassium-rich foods while on ACE inhibitors, but the primary concern with salt substitutes is their potassium content.

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