Nursing Elites

1. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

• A. This medication can stain your contacts.
• B. This medication can cause your pupils to constrict.
• C. This medication can absorb into your contacts.
• D. This medication can slow your heart rate.

Correct answer: C

Rationale: The correct answer is C. Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove their contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid potential absorption of the medication by the lenses. Choices A, B, and D are incorrect because Brimonidine's main concern with contact lenses is its absorption into the lenses rather than staining contacts, causing pupil constriction, or affecting heart rate.

2. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

3. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

4. A client is starting therapy with raloxifene. Which adverse effect should the client monitor for as instructed by the nurse?

• A. Leg cramps
• B. Hot flashes
• C. Urinary frequency
• D. Hair loss

Correct answer: B

Rationale: Hot flashes are a common adverse effect associated with raloxifene therapy. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women. Hot flashes are a well-known side effect of SERMs due to their estrogen-like effects on the body. Leg cramps, urinary frequency, and hair loss are not typically associated with raloxifene therapy. Therefore, the nurse should instruct the client to monitor for hot flashes as part of the medication education.

5. When providing discharge instructions to a client with a new prescription for Levofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking Levofloxacin with dairy products. This is because calcium in dairy products can interfere with the absorption of the medication. Patients should be advised to take Levofloxacin either 1 hour before or 2 hours after consuming dairy products to ensure optimal effectiveness. Choice A is incorrect because Levofloxacin can be taken with or without food. Choice C is incorrect as the timing of Levofloxacin administration is not specified as at bedtime. Choice D is also incorrect as there is no need to increase intake of potassium-rich foods specifically for Levofloxacin administration.

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