Nursing Elites

1. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following foods should the provider instruct the client to avoid?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients taking Warfarin should avoid foods high in vitamin K, such as broccoli, as they can interfere with the effectiveness of the medication. Vitamin K can counteract the anticoagulant effects of Warfarin, potentially leading to blood clotting issues. Broccoli is rich in vitamin K, so its consumption should be consistent to avoid fluctuations in the medication's effectiveness. Bananas, chicken, and potatoes are not known to significantly interact with Warfarin and do not pose a risk of affecting its anticoagulant properties.

2. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure. Choice A: Weight loss may be expected in heart failure patients due to fluid retention, but it is not an immediate concern. Choice B: A blood pressure of 104/60 mm Hg is slightly low but not a priority compared to the indication of kidney dysfunction. Choice C: A potassium level of 3.5 mEq/L is within the normal range, so it does not require immediate reporting.

3. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: Fever is a key symptom of serotonin syndrome, a potentially serious condition that can occur with the use of SSRIs like Sertraline. Serotonin syndrome is characterized by excessive levels of serotonin in the body, leading to symptoms such as fever, agitation, confusion, tremors, and sweating. If a client on Sertraline presents with fever, the nurse should consider the possibility of serotonin syndrome and take appropriate actions such as notifying the healthcare provider and monitoring the client closely. Bruising, abdominal pain, and rash are not typically associated with serotonin syndrome and are more likely to be indicative of other conditions or side effects.

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

• A. Drink 2 liters of water daily.
• B. Avoid taking the medication on an empty stomach.
• C. Limit vitamin C intake while taking this medication.
• D. Take an iron supplement while on this medication.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol is to drink 2 liters of water daily. This helps reduce the risk of kidney stones, a potential side effect of allopurinol use. Adequate hydration is essential to prevent kidney stone formation and maintain kidney function while taking this medication.

5. A healthcare professional is preparing to administer Butorphanol to a client who has a history of substance use disorder. The healthcare professional should identify which of the following information as true regarding Butorphanol?

• A. Butorphanol has a greater risk of abuse than morphine.
• B. Butorphanol causes a higher incidence of respiratory depression than morphine.
• C. Butorphanol cannot be reversed with an opioid antagonist.
• D. Butorphanol can cause abstinence syndrome in opioid-dependent clients.

Correct answer: D

Rationale: Corrected Rationale: Butorphanol, an opioid agonist/antagonist, can lead to abstinence syndrome in clients who are opioid-dependent. This syndrome may present with symptoms like abdominal pain, fever, and anxiety. It is crucial for healthcare professionals to consider this risk when administering Butorphanol to clients with a history of substance use disorder. Choices A, B, and C are incorrect. Butorphanol is less likely to be abused than morphine, causes less respiratory depression than morphine, and can be reversed with an opioid antagonist.

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