Nursing Elites

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

• A. Drink 2 liters of water daily.
• B. Avoid taking the medication on an empty stomach.
• C. Limit vitamin C intake while taking this medication.
• D. Take an iron supplement while on this medication.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol is to drink 2 liters of water daily. This helps reduce the risk of kidney stones, a potential side effect of allopurinol use. Adequate hydration is essential to prevent kidney stone formation and maintain kidney function while taking this medication.

2. A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: To minimize the risk of catheter embolism, it is crucial to avoid reinserting the needle into an IV catheter. This practice can potentially sever the end of the catheter, leading to catheter embolism. Proper insertion techniques, securement, and avoiding unnecessary manipulations of the catheter can help prevent this serious complication.

3. ACE Inhibitors are used in the treatment of all EXCEPT:

• A. Hypertension
• B. Heart Failure
• C. Hypotension
• D. Diabetic nephropathy

Correct answer: C

Rationale: ACE inhibitors are commonly used in the treatment of hypertension, heart failure, and diabetic nephropathy due to their ability to reduce blood pressure, improve heart function, and protect the kidneys. However, they are not indicated for hypotension as they can further lower blood pressure, worsening the condition. Therefore, the correct answer is C. Choice A, hypertension, is correct as ACE inhibitors are a first-line treatment for this condition. Choice B, heart failure, is also correct as ACE inhibitors help improve heart function in patients with heart failure. Choice D, diabetic nephropathy, is correct as ACE inhibitors can slow the progression of kidney damage in diabetic patients.

4. When providing teaching to a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a side effect that affects the gums. It is crucial for the client to maintain good oral hygiene to prevent oral health complications. Choices A, B, and D are incorrect. While the timing of medication administration and dietary considerations are important, they are not directly related to preventing the specific side effect of gingival hyperplasia caused by Phenytoin.

5. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

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