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 prescription for Amphotericin B. Which of the following laboratory values should be monitored by the nurse to assess for an adverse effect of this medication?

• A. Serum creatinine.
• B. Serum potassium.
• C. Serum sodium.
• D. Serum calcium.

Correct answer: A

Rationale: Corrected Rationale: Amphotericin B is known to cause nephrotoxicity, a potential adverse effect that can be monitored by checking the client's serum creatinine levels. Regular monitoring of serum creatinine helps in early identification of kidney damage and allows for timely intervention to prevent further complications. Choice B, serum potassium, is not typically associated with adverse effects of Amphotericin B. Choice C, serum sodium, and choice D, serum calcium, are not directly affected by Amphotericin B and are not primary indicators of its adverse effects.

3. A healthcare professional is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the healthcare professional expect to cause an adverse effect when administered concurrently with Fentanyl?

• A. Ampicillin
• B. Diazepam
• C. Furosemide
• D. Prednisone

Correct answer: B

Rationale: Diazepam, a CNS depressant, can lead to severe sedation when administered concurrently with an opioid like Fentanyl due to their additive central nervous system depressant effects. This interaction can potentiate respiratory depression and other CNS effects, increasing the risk of adverse outcomes.

4. When teaching a client with a new prescription for Clopidogrel, which laboratory value should the nurse monitor to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication that works by reducing the formation of blood clots. Therefore, the nurse should monitor the client's platelet count to assess for potential bleeding complications. A decrease in platelet count could indicate a risk of bleeding, which is an adverse effect associated with Clopidogrel therapy. Monitoring other laboratory values like white blood cell count, hemoglobin, and blood glucose is important for assessing overall health status but is not directly related to the potential adverse effects of Clopidogrel.

5. While caring for a client on long-term aspirin therapy, the nurse should monitor the client for which of the following complications?

• A. Hemorrhagic stroke
• B. Thromboembolic stroke
• C. Iron deficiency anemia
• D. Neutropenia

Correct answer: A

Rationale: Corrected Rationale: Long-term aspirin therapy can increase the risk of hemorrhagic stroke due to its antiplatelet effects, which can lead to bleeding complications. Aspirin inhibits platelet function, potentially causing bleeding in the brain and increasing the risk of a hemorrhagic stroke. Choice B, thromboembolic stroke, is incorrect because aspirin therapy is actually used to prevent thromboembolic events by inhibiting platelet aggregation. Choices C and D, iron deficiency anemia and neutropenia, are not directly associated with long-term aspirin therapy.

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