Nursing Elites

1. When providing discharge instructions to a client prescribed Warfarin, which herbal supplement should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by interacting with its metabolism. While garlic and ginseng are also known to interact with Warfarin, the specific supplement the nurse should instruct the client to avoid in this scenario is St. John's wort. Echinacea, although an herbal supplement, is not typically associated with significant interactions with Warfarin and is not the primary concern in this case.

2. A client with schizophrenia is being taught strategies to cope with anticholinergic effects of Fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: Chewing sugarless gum is an effective strategy to manage dry mouth, a common anticholinergic effect of Fluphenazine. By stimulating saliva production, sugarless gum helps to moisten the mouth and alleviate the discomfort associated with dryness. This intervention can improve the client's oral health and overall comfort while taking the medication. The other options are not directly related to alleviating anticholinergic effects. Taking the medication in the morning to prevent insomnia does not address anticholinergic effects specifically. Using cooling measures to decrease fever is not relevant to managing dry mouth caused by anticholinergic effects. Taking an antacid to relieve nausea is unrelated to managing dry mouth, which is the focus of anticholinergic effects.

3. A healthcare provider is providing teaching to a client who has a new prescription for metronidazole. The healthcare provider should instruct the client to avoid which of the following?

• A. Dairy products
• B. Alcohol
• C. Leafy green vegetables
• D. Grapefruit juice

Correct answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole due to the risk of a disulfiram-like reaction. This reaction can cause symptoms like flushing, headache, nausea, and vomiting when alcohol is consumed while on metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole. Dairy products do not interfere with metronidazole absorption; leafy green vegetables are safe to consume as they do not affect metronidazole metabolism, and grapefruit juice is not contraindicated with metronidazole.

4. A client presents in the Emergency Department with chest pain. Which of the following conditions is least likely to cause chest pain?

• A. Arthritis
• B. Peptic ulcer disease
• C. Myocardial infarction
• D. Gastric reflux

Correct answer: A

Rationale: Arthritis is a condition primarily affecting the joints and is not known to cause chest pain. Peptic ulcer disease, myocardial infarction, and gastric reflux are conditions that can present with chest pain due to various reasons such as inflammation, ischemia, or reflux of stomach acid into the esophagus, respectively.

5. A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included?

• A. Take the medication with food to reduce nausea.
• B. Take the medication first thing in the morning on an empty stomach.
• C. Take the medication with a full glass of milk.
• D. Take the medication with meals.

Correct answer: B

Rationale: Alendronate should be taken first thing in the morning on an empty stomach to maximize absorption. Taking it with food, milk, or meals can reduce its effectiveness by impairing absorption. Therefore, advising the client to take it on an empty stomach is crucial for optimal therapeutic outcomes.

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