Nursing Elites

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

• A. Notify the provider if you plan to become pregnant.
• B. Take the medication 1 hr before you plan to go to sleep.
• C. Allow at least 6 hr for sleep when taking Zolpidem.
• D. To increase the effectiveness of Zolpidem, take it with a bedtime snack.

Correct answer: A

Rationale: Zolpidem is classified under Pregnancy Risk Category C. It is essential for the client to inform the provider if she plans to become pregnant as Zolpidem use during pregnancy may pose risks to the fetus. This precaution allows for appropriate assessment and possible adjustments to the treatment plan to ensure the safety of both the client and the developing baby. Choice B is incorrect because Zolpidem is usually taken immediately before bedtime, not 1 hour before. Choice C is incorrect as Zolpidem is known for its quick onset of action, and the client does not need to allocate a specific amount of time for sleep. Choice D is incorrect as taking Zolpidem with food, especially a bedtime snack, may delay its onset of action.

2. When teaching a client with a new prescription for furosemide, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for furosemide, a diuretic, is to take it in the morning to prevent nocturia. Taking it in the morning helps to prevent frequent urination during the night, allowing the client to have uninterrupted sleep. This timing also coincides with the body's natural diuretic response, which is typically more active during the day. Choices B, C, and D are incorrect because furosemide does not require avoiding foods high in potassium, taking it on an empty stomach, or limiting fluid intake to 1 liter per day.

3. A client is being educated by a healthcare provider about managing Digoxin toxicity. Which statement by the client demonstrates an understanding of the teaching?

• A. I will take an extra dose of Digoxin if I miss one.
• B. I should notify my healthcare provider if I experience visual changes.
• C. I will stop taking Digoxin if my heart rate is below 70 bpm.
• D. I should take antacids to alleviate gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is B. Visual changes, such as yellow or blurred vision, can be indicative of digoxin toxicity. It is crucial for clients to inform their healthcare provider promptly if they encounter these symptoms. Prompt medical attention can help manage potential toxicity and prevent complications. Choices A, C, and D are incorrect because taking an extra dose of Digoxin, stopping Digoxin based on heart rate alone, and using antacids for gastrointestinal upset are not appropriate actions when managing Digoxin toxicity.

4. When teaching the parents of a child who has a new prescription for Desipramine, which of the following adverse effects should the nurse instruct the parents is the priority to report to the provider?

• A. Constipation
• B. Suicidal thoughts
• C. Photophobia
• D. Dry mouth

Correct answer: B

Rationale: The priority adverse effect to report when a child is taking Desipramine is suicidal thoughts. Desipramine can lead to an increased risk of suicidal thoughts and behaviors. The nurse should emphasize to the parents the importance of monitoring the child for any signs of worsening depression or suicidal ideation. Prompt reporting of such symptoms can help prevent harm to the child. Choices A, C, and D are not the priority adverse effects associated with Desipramine. While constipation, photophobia, and dry mouth can occur as side effects of Desipramine, they are not as critical as the risk of suicidal thoughts, which requires immediate attention to ensure the safety of the child.

5. A client has a new prescription for Filgrastim to treat neutropenia. Which of the following statements should the nurse include?

• A. This medication will help increase your white blood cell count.
• B. This medication will help reduce your risk of infection.
• C. This medication will help improve your red blood cell count.
• D. This medication will help increase your platelet count.

Correct answer: A

Rationale: The correct statement the nurse should include is that 'This medication will help increase your white blood cell count.' Filgrastim is a medication used to stimulate the production of white blood cells, specifically neutrophils, to increase the white blood cell count. This increase in white blood cells helps reduce the risk of infections in clients with neutropenia. Choices B, C, and D are incorrect because Filgrastim specifically targets white blood cells, not red blood cells or platelets.

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