Nursing Elites

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

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

Correct answer: A

Rationale: The correct instruction for a client prescribed Clopidogrel is to avoid taking aspirin while on this medication. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs can potentiate the risk of bleeding, so they should be avoided while taking Clopidogrel to prevent adverse effects. Choices B, C, and D are incorrect because Clopidogrel does not need to be taken with food, there is no specific dietary restriction related to potassium, and the timing of administration (bedtime) is not a critical instruction for this medication.

2. A client has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?

• A. INR of 4.0
• B. Potassium level of 4.5 mEq/L
• C. Sodium level of 140 mEq/L
• D. Creatinine level of 1.0 mg/dL

Correct answer: A

Rationale: An INR of 4.0 is above the therapeutic range for a client on Warfarin, indicating an increased risk of bleeding. This finding requires immediate reporting to the provider for appropriate intervention to prevent complications associated with excessive anticoagulation. Potassium, sodium, and creatinine levels are within normal ranges and are not directly related to the risk of bleeding in a client on Warfarin therapy.

3. A client is being discharged with a new prescription for furosemide 40 mg PO daily. Which of the following instructions should be included?

• A. Avoid foods rich in potassium.
• B. Take the medication with food.
• C. Weigh yourself daily.
• D. Stand up slowly to minimize orthostatic hypotension.

Correct answer: D

Rationale: The correct answer is D: 'Stand up slowly to minimize orthostatic hypotension.' Clients prescribed furosemide are at risk for orthostatic hypotension, a sudden drop in blood pressure when changing positions. Advising the client to stand up slowly can help prevent this complication. Instructing the client to avoid rapid position changes decreases the likelihood of dizziness or fainting episodes. Choices A, B, and C are incorrect because furosemide does not require avoiding potassium-rich foods, taking the medication with food, or daily weighing as specific instructions.

4. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

5. What is one of the therapeutic uses of Valproate?

• A. Suppression of seizure activity
• B. Replacement of hypothyroidism to restore normal hormone balance
• C. Maintenance of blood glucose
• D. Lowering of blood pressure

Correct answer: A

Rationale: Valproate, also known as Valproic acid, is commonly used in medicine for the suppression of seizure activity. It is an anticonvulsant medication that helps manage and prevent seizures in various conditions such as epilepsy. While it is not used for replacing hypothyroidism, maintaining blood glucose levels, or lowering blood pressure, its primary therapeutic use is in managing seizures.

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