Nursing Elites

1. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. To ensure optimal absorption, the client should alternate nostrils daily when inhaling the medication. This practice helps prevent irritation and promotes consistent drug delivery through both nostrils. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed as a tablet, applied topically, or mixed with juice; it is usually administered intranasally.

2. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.

3. A client has a new prescription for Iron supplements. Which of the following instructions should be included in the teaching?

• A. Take the medication with a glass of orange juice.
• B. Avoid taking the medication with milk.
• C. Increase fiber intake to prevent constipation.
• D. Expect stools to be dark.

Correct answer: C

Rationale: The correct answer is to increase fiber intake to prevent constipation when taking iron supplements. Iron supplements can lead to constipation as a common side effect. Increasing fiber intake helps promote healthy bowel movements and counteracts the constipating effects of iron. Choice A is incorrect because iron absorption is hindered by calcium found in milk. Choice B is incorrect as orange juice enhances iron absorption due to its vitamin C content. Choice D is incorrect as iron supplements can cause stools to appear dark, not bright red.

4. When teaching a client with a new prescription for Simvastatin, which instruction should be included?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for Simvastatin is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Simvastatin, leading to increased blood levels of the drug and a higher risk of adverse effects such as muscle pain and liver damage. It is important to educate the client about this potential interaction to ensure the safe and effective use of the medication. Choices A, C, and D are incorrect because taking Simvastatin with food or in the morning and increasing potassium-rich foods intake are not specifically related to the safe use of Simvastatin. Avoiding grapefruit juice is crucial to prevent drug interactions.

5. When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril. Choices B, C, and D are incorrect because Lisinopril is typically taken once a day in the morning, it can lead to hyperkalemia (so increasing potassium-rich foods is not advised), and it can be taken with or without food.

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