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. At what amount does Acetaminophen stop effectively controlling pain?

• A. Over 1,000 mg
• B. 750 mg
• C. Over 1,500 mg
• D. 150 mg

Correct answer: A

Rationale: Acetaminophen is known to lose its effectiveness in controlling pain beyond a dosage of 1,000 mg. Taking more than 1,000 mg will not provide additional pain relief but can increase the risk of adverse effects. Choice B (750 mg) is incorrect because this amount is within the typical recommended dose range for Acetaminophen. Choice C (Over 1,500 mg) is incorrect as it suggests a higher dose than the point at which Acetaminophen starts to lose its effectiveness. Choice D (150 mg) is too low a dose to effectively control pain for most adults.

3. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

4. A client has a new prescription for Hydroxychloroquine to treat Lupus Erythematosus. Which of the following adverse effects should the nurse include in the teaching?

• A. Nausea
• B. Hair loss
• C. Eye damage
• D. Drowsiness

Correct answer: C

Rationale: The correct answer is 'C: Eye damage.' Hydroxychloroquine can cause severe adverse effects on the eyes, such as retinopathy, which can lead to permanent visual impairment. It is essential for clients to be aware of this potential adverse effect and report any changes in vision promptly. Choices A, B, and D are incorrect because although nausea, hair loss, and drowsiness can occur with Hydroxychloroquine, they are not as severe or critical as the risk of eye damage.

5. A client is receiving treatment with carboplatin. Which of the following findings should the nurse monitor?

• A. Hyperglycemia
• B. Ototoxicity
• C. Hypertension
• D. Bradycardia

Correct answer: B

Rationale: Corrected Rationale: Carboplatin is known to cause ototoxicity as a serious adverse effect. It is essential for the nurse to monitor the client for any signs or symptoms of hearing loss or other auditory issues to address them promptly. Incorrect Choices Rationale: A) Hyperglycemia is not a common side effect associated with carboplatin. C) Hypertension is not a typical finding to monitor for specifically related to carboplatin treatment. D) Bradycardia is not a primary concern when monitoring a client on carboplatin.

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