Nursing Elites

1. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication on an empty stomach.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.

2. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously for Rheumatoid Arthritis. Injection-site reactions such as redness and swelling are common. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for potential adverse effects.

3. When teaching a client with a prescription for long-term use of oral prednisone for chronic asthma, the nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Weight gain and fluid retention are common adverse effects of oral prednisone due to sodium and water retention. Patients on long-term prednisone therapy should be advised to monitor their weight closely and report any significant changes to their healthcare provider. Choice B, 'Nervousness,' is not typically associated with oral prednisone use. Choice C, 'Bradycardia,' refers to a slow heart rate, which is not a common adverse effect of prednisone. Choice D, 'Constipation,' is not a typical adverse effect of oral prednisone; instead, gastrointestinal disturbances like increased appetite or even peptic ulcer disease may occur.

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

• A. Take this medication at bedtime.
• B. Monitor for signs of hyperglycemia.
• C. Avoid drinking grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct instruction for a client prescribed Verapamil is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication. This can result in a higher risk of adverse effects, such as hypotension and bradycardia. Therefore, it is essential for the client to avoid grapefruit juice while taking Verapamil to prevent potential complications. Choices A, B, and D are incorrect because taking Verapamil at bedtime, monitoring for signs of hyperglycemia, and increasing potassium-rich foods intake are not specific instructions related to Verapamil therapy and do not address the potential interaction with grapefruit juice.

5. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital, with a long half-life of 4 days, remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should administer phenobarbital once a day to maintain a consistent therapeutic effect without the need for multiple daily doses. Administering the medication more than once a day would not be necessary and could increase the risk of side effects or toxicity. Therefore, the correct answer is to administer phenobarbital once a day.

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