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. What is the antidote for Heparin?

• A. Protamine sulfate
• B. Vitamin K
• C. Naloxone
• D. Toradol

Correct answer: A

Rationale: The correct answer is A: Protamine sulfate. Heparin is an anticoagulant that prevents blood clotting. Protamine sulfate is the antidote for Heparin as it binds to heparin, neutralizing its anticoagulant effects. Vitamin K is not the antidote for Heparin; it is used to reverse the effects of warfarin, another anticoagulant. Naloxone is an opioid antagonist for opioids, and Toradol is a nonsteroidal anti-inflammatory drug (NSAID) for pain relief. Therefore, the correct antidote for Heparin is Protamine sulfate.

3. A client is starting therapy with topotecan. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

4. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

5. A client receives a new prescription for NRTIs for HIV treatment. Which statement should the nurse include during teaching about these medications?

• A. These medications work by inhibiting enzymes to prevent HIV replication.
• B. These medications work by preventing protein synthesis within the HIV cell.
• C. These medications work by weakening the cell wall of the HIV virus.
• D. These medications work by blocking HIV entry into cells.

Correct answer: A

Rationale: NRTIs inhibit the enzyme reverse transcriptase, essential for HIV replication. By preventing this process, viral replication is hindered, ultimately reducing the viral load in the body. Option A correctly explains the mechanism of action of NRTIs in treating HIV infection. Choices B, C, and D describe mechanisms of action that do not align with how NRTIs work in HIV treatment. B is incorrect because NRTIs do not target protein synthesis within the HIV cell. C is incorrect as NRTIs do not affect the cell wall of the HIV virus. D is incorrect because NRTIs do not block HIV entry into cells.

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