Nursing Elites

1. A client has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

• A. Take the medication with food.
• B. Plan to take the medication at bedtime.
• C. Expect increased swelling of the ankles.
• D. Fluid intake should be limited in the morning.

Correct answer: A

Rationale: The correct answer is to take the medication with food. Hydrochlorothiazide should be taken with or after meals to prevent gastrointestinal upset. Taking it with food can help reduce the chances of stomach discomfort or nausea. It is not necessary to take the medication at bedtime, expect increased swelling of the ankles, or limit fluid intake in the morning when taking Hydrochlorothiazide. Therefore, choices B, C, and D are incorrect.

2. A client has a new prescription for Maraviroc to treat HIV infection. The healthcare provider should monitor the client for which of the following adverse reactions?

• A. Liver failure
• B. Kidney failure
• C. Pancreatitis
• D. Severe allergic reactions

Correct answer: D

Rationale: The correct answer is D: Severe allergic reactions. Maraviroc, used to treat HIV infection, can lead to severe allergic reactions, including hepatotoxicity. While liver failure is a potential adverse effect, it is often preceded by hepatotoxicity manifestations like jaundice or right upper quadrant pain. Kidney failure and pancreatitis are not typically associated with Maraviroc use. Therefore, monitoring for signs of severe allergic reactions and hepatotoxicity is crucial for early detection and intervention.

3. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

4. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.

5. When teaching a client who has a new prescription for Ciprofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with an antacid.
• B. Avoid direct sunlight.
• C. Increase your intake of dairy products.
• D. Expect urine to turn orange.

Correct answer: B

Rationale: The correct instruction for a client prescribed Ciprofloxacin is to avoid direct sunlight. Ciprofloxacin can cause photosensitivity, increasing the risk of sunburn. Clients should be advised to avoid direct sunlight and wear protective clothing, including hats and sunglasses when going outdoors to prevent skin damage. Choices A, C, and D are incorrect. Taking Ciprofloxacin with an antacid can reduce its absorption, so they should not be taken together. Increasing dairy product intake is not necessary or relevant to taking Ciprofloxacin. While Ciprofloxacin can discolor urine, turning it orange, this is not a critical side effect that requires specific instructions for the client.

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