Nursing Elites

1. A client reports taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: The correct answer is C, Warfarin. Aspirin increases the effect of anticoagulants like warfarin by inhibiting platelet aggregation, leading to an increased risk of bleeding. Therefore, the use of aspirin is generally contraindicated for clients taking warfarin. Choices A, B, and D are not contraindicated with aspirin. Digoxin, Metformin, and Nitroglycerin do not have significant interactions with Aspirin, unlike Warfarin, making them safe to use concomitantly.

2. When starting therapy with cisplatin, a client should report which of the following adverse effects as instructed by the nurse?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The nurse should instruct the client to report tinnitus because it can be an indication of ototoxicity, a potential adverse effect of cisplatin. Ototoxicity can manifest as tinnitus, hearing loss, or balance disturbances, so it is crucial for the client to promptly report any changes in hearing such as tinnitus to prevent further damage.

3. A healthcare professional is educating a client who has a new prescription for warfarin. Which of the following statements should the healthcare professional include?

• A. Avoid foods high in vitamin K.
• B. Report any signs of bleeding to your healthcare provider.
• C. Use a soft toothbrush to prevent gum bleeding.
• D. Use an electric razor to prevent cuts.

Correct answer: B

Rationale: The correct statement that the healthcare professional should include when educating a client prescribed warfarin is to report any signs of bleeding to their healthcare provider. Bleeding can indicate excessive anticoagulation, which is a serious side effect of warfarin. Prompt reporting of bleeding symptoms is crucial to prevent complications. Choices A, C, and D are incorrect. While avoiding foods high in vitamin K may be important when taking warfarin due to its interaction with the medication, it is not the priority over reporting signs of bleeding. Using a soft toothbrush and electric razor are general precautions for individuals on anticoagulants but are not as critical as reporting bleeding symptoms.

4. When preparing to administer IV Acyclovir for Herpes Zoster, what action should the nurse take?

• A. Infuse the medication over 1 hour.
• B. Monitor the client's blood pressure every 15 minutes during infusion.
• C. Administer a stool softener.
• D. Monitor the client's blood glucose level every 4 hours during infusion.

Correct answer: A

Rationale: The correct action for the nurse is to infuse IV Acyclovir over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects, so a slow infusion rate is crucial for patient safety. Monitoring blood pressure, administering a stool softener, or monitoring blood glucose levels are not directly related to the administration of IV Acyclovir for Herpes Zoster.

5. A healthcare professional reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once daily. The healthcare professional should identify this as which of the following types of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates that the medication is to be administered on a regular schedule, typically daily, without a specified termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily is to be given regularly until the healthcare provider decides to discontinue it. This type of prescription is common for medications that are part of the client's ongoing treatment regimen. The other choices are incorrect: 'Single' does not provide information about the frequency or duration of administration, 'Stat' indicates an urgent, one-time administration, and 'Standing' refers to a prescription that is automatically renewed without the need for a new order for each administration.

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