Nursing Elites

1. A client is starting therapy with Metformin. Which of the following instructions should the nurse include?

• A. Take this medication with your first bite of food.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. Instructing the client to take the medication with the first bite of food helps in achieving optimal effectiveness and minimizes the risk of side effects like nausea or upset stomach. Choice B is incorrect because taking Metformin on an empty stomach can lead to increased gastrointestinal side effects. Choice C is incorrect as there is no specific timing requirement for taking Metformin before bedtime. Choice D is incorrect as Metformin is usually taken daily, not every other day.

2. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following herbal supplements 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 can reduce the effectiveness of Warfarin by interacting with its metabolism pathways, potentially leading to decreased anticoagulant effects. Therefore, clients on Warfarin therapy should avoid St. John's wort. While echinacea, garlic, and ginseng are also herbal supplements that can interact with Warfarin, St. John's wort is particularly known for its significant impact on Warfarin metabolism. Echinacea may increase the risk of bleeding when taken with Warfarin, garlic may potentiate the anticoagulant effects of Warfarin, and ginseng may also increase the risk of bleeding. However, St. John's wort is the most crucial to avoid due to its significant impact on Warfarin metabolism.

3. A client has a new prescription for Cyclobenzaprine to treat muscle spasms. Which of the following instructions should the nurse include in the teaching?

• A. Avoid driving or operating heavy machinery while taking this medication.
• B. Take this medication on an empty stomach for best results.
• C. Take this medication only when experiencing muscle pain.
• D. Increase your intake of potassium-rich foods while taking this medication.

Correct answer: A

Rationale: The correct instruction that the nurse should include in the teaching for a client prescribed Cyclobenzaprine is to avoid driving or operating heavy machinery while taking this medication. Cyclobenzaprine can cause drowsiness, so it is important to advise clients to avoid activities that require alertness and coordination to prevent accidents or injuries. Choice B is incorrect because Cyclobenzaprine can be taken with or without food. Choice C is incorrect because Cyclobenzaprine is typically taken regularly as prescribed, not just when experiencing muscle pain. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Cyclobenzaprine.

4. A client is receiving treatment with bevacizumab. Which of the following findings should the nurse monitor?

• A. Hypertension
• B. Hypokalemia
• C. Hyperglycemia
• D. Hypocalcemia

Correct answer: A

Rationale: Correct Answer: A. Bevacizumab is known to cause hypertension as a common adverse effect. The nurse should closely monitor the client's blood pressure to detect and manage this potential side effect promptly. Choice B, hypokalemia, is not typically associated with bevacizumab treatment. Choice C, hyperglycemia, is not a common adverse effect of bevacizumab. Choice D, hypocalcemia, is not a recognized side effect of bevacizumab.

5. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

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