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 has a new prescription for Clonidine. What instruction should the nurse include during teaching?

• A. Take the medication with food.
• B. Expect to feel drowsy or lightheaded.
• C. Increase your fluid intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: The correct instruction when teaching a client about Clonidine is to expect to feel drowsy or lightheaded. Clonidine can cause these side effects, especially when starting the medication. The nurse should advise the client to avoid activities that require alertness until they understand how the medication affects them. Choices A, C, and D are incorrect because taking Clonidine with food, increasing fluid intake, or avoiding foods high in fat are not specific instructions related to managing the side effects of Clonidine.

3. What is a common side effect of Albuterol?

• A. Paradoxical Bronchospasm
• B. Diarrhea
• C. Seizures
• D. Vision Loss

Correct answer: A

Rationale: A common side effect of Albuterol is paradoxical bronchospasm, a condition where the airways become more constricted instead of relaxing. This can be a serious adverse reaction to the medication. Choices B, C, and D are incorrect as they are not commonly associated with Albuterol use. Diarrhea and seizures are not typically reported side effects of Albuterol, and vision loss is not a recognized side effect of this medication.

4. A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.

5. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

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