Nursing Elites

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

• A. Take this medication at bedtime.
• B. Take this medication with food.
• C. Take this medication on an empty stomach in the morning.
• D. Take this medication with an antacid.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance its absorption. This timing allows for optimal absorption and effectiveness of the medication. Taking it with food, at bedtime, or with an antacid may interfere with its absorption and reduce its efficacy.

2. How can the nurse best explain the difference between angina and a myocardial infarction to a client presenting with severe chest pain?

• A. “Angina usually resolves with rest, and is rarely fatal, while a myocardial infarction necessitates immediate treatment and can be life-threatening.”
• B. “There is a clear distinction between the two. You will receive treatment based on the diagnosis of a myocardial infarction.”
• C. “Both conditions result from a clot obstructing the coronary arteries. Angina occurs with the blockage of a small vessel, whereas a myocardial infarction occurs with a blockage of a large vessel.”
• D. “Angina may not cause as intense chest pain, whereas a myocardial infarction always presents with severe chest pain.”

Correct answer: A

Rationale: When educating a client about the differences between angina and a myocardial infarction, it is crucial to emphasize key distinguishing factors. Angina typically improves with rest and is not usually life-threatening, whereas a myocardial infarction requires urgent intervention as it can be life-threatening. This explanation helps the client understand the urgency and severity associated with a myocardial infarction compared to angina.

3. When administering subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty, what action should the nurse plan to take?

• A. Expel any air bubbles from the prefilled syringe before injecting.
• B. Insert the needle completely into the client's tissue.
• C. Administer the injection in the client's thigh.
• D. Aspirate carefully after inserting the needle into the client's skin.

Correct answer: B

Rationale: When administering enoxaparin via a prefilled syringe for deep subcutaneous injection, the nurse should insert the needle completely into the client's tissue. This action ensures proper delivery of the medication into the subcutaneous layer, promoting optimal therapeutic effects. Choice A is incorrect because there is no need to expel air bubbles from a prefilled syringe. Choice C is incorrect as enoxaparin is typically administered in the abdomen for subcutaneous injections. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or damage to tissues.

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

• A. Avoid taking aspirin while on this medication.
• B. Take this medication with food.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid taking aspirin while on Clopidogrel. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs can further potentiate this risk, so they should be avoided while taking Clopidogrel to reduce the chance of bleeding complications. Choices B, C, and D are incorrect. There is no specific instruction to take Clopidogrel with food or at bedtime. Avoiding foods high in potassium is not directly related to Clopidogrel use.

5. When teaching a client with a prescription for Cephalexin, which of the following instructions should the nurse include?

• A. Take the medication with an antacid.
• B. Avoid dairy products while taking this medication.
• C. Expect your stools to turn black.
• D. Complete the full course of medication.

Correct answer: D

Rationale: The correct instruction for a client prescribed with Cephalexin is to complete the full course of medication. This is crucial to ensure the infection is completely treated and to reduce the risk of antibiotic resistance. Choices A, B, and C are incorrect. Taking Cephalexin with an antacid is generally not recommended as it may reduce its effectiveness. While dairy products can interfere with certain antibiotics, they do not have a direct interaction with Cephalexin. Stools turning black is not an expected side effect of Cephalexin.

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