Nursing Elites

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

• A. Take this medication with meals.
• B. Avoid drinking grapefruit juice.
• C. Take this medication at bedtime.
• D. Increase your intake of sodium-rich foods.

Correct answer: B

Rationale: The correct instruction the nurse should include is to advise the client to avoid drinking grapefruit juice while taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the medication and raising the risk of adverse effects, such as cardiac toxicity. Choices A, C, and D are incorrect. Taking Amiodarone with meals, at bedtime, or increasing intake of sodium-rich foods are not necessary instructions for this medication.

2. A client informs the nurse about taking Gingko Biloba. Which of the following medications is contraindicated for a client taking Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: The correct answer is B, Warfarin. Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction. Gingko Biloba can suppress coagulation and increase the risk of bleeding or hemorrhage when taken with anticoagulants like Warfarin. Acetaminophen (choice A), Digoxin (choice C), and Lisinopril (choice D) do not have significant interactions with Gingko Biloba.

3. A healthcare provider is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The provider should recognize which of the following conditions is a contraindication for taking propranolol?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Asthma. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms. Choices B, C, and D are incorrect. Glaucoma, hypertension, and tachycardia are not contraindications for taking propranolol. In fact, propranolol is commonly used to treat hypertension and tachycardia.

4. A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?

• A. Sodium 140 mEq/L
• B. Potassium 4.5 mEq/L
• C. BUN 55 mg/dL
• D. Glucose 120 mg/dL

Correct answer: C

Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.

5. A client has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

• A. Take the medication with food.
• B. Plan to take the medication at bedtime.
• C. Expect increased swelling of the ankles.
• D. Limit fluid intake in the morning.

Correct answer: A

Rationale: When educating a client about taking Hydrochlorothiazide, the nurse should advise taking the medication with food or after meals to prevent gastrointestinal upset. This medication is a diuretic, so it is important to maintain adequate fluid intake throughout the day to prevent dehydration. Taking it at bedtime is not necessary, and increased swelling of the ankles is not an expected side effect of this medication. Limiting fluid intake in the morning is not necessary and could lead to dehydration, which is a potential side effect of this diuretic.

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