Nursing Elites

1. When teaching a client with a new prescription for furosemide, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for furosemide, a diuretic, is to take it in the morning to prevent nocturia. Taking it in the morning helps to prevent frequent urination during the night, allowing the client to have uninterrupted sleep. This timing also coincides with the body's natural diuretic response, which is typically more active during the day. Choices B, C, and D are incorrect because furosemide does not require avoiding foods high in potassium, taking it on an empty stomach, or limiting fluid intake to 1 liter per day.

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

• A. Notify the provider if you plan to become pregnant.
• B. Take the medication 1 hour before planning to go to sleep.
• C. Allow at least 6 hours for sleep when taking zolpidem.
• D. Do not take zolpidem with a bedtime snack.

Correct answer: A

Rationale: Zolpidem is classified as Pregnancy Risk Category C. It is important for the client to inform the provider if they plan to become pregnant because the medication may need to be adjusted or changed to ensure the safety of the fetus. This communication allows for appropriate monitoring and adjustments to be made to the treatment plan. Choice B is incorrect because zolpidem should be taken just before going to bed, not specifically 1 hour before. Choice C is incorrect as zolpidem is a short-acting medication, and it does not require a full 6 hours for sleep. Choice D is incorrect because zolpidem can be taken with or without food, so taking it with a bedtime snack is not contraindicated.

3. A client has a new prescription for Metformin to treat type 2 diabetes. Which of the following laboratory results should be monitored?

• A. Hemoglobin A1C
• B. Liver function tests
• C. Electrolyte levels
• D. Kidney function

Correct answer: D

Rationale: Metformin is excreted by the kidneys, and impaired kidney function can lead to an increased risk of lactic acidosis, a serious side effect. Therefore, it is important to monitor kidney function regularly while a client is on Metformin. Hemoglobin A1C is used to monitor long-term glucose control, but kidney function is the priority for monitoring Metformin therapy.

4. When starting therapy with raloxifene, a client should monitor for which of the following adverse effects?

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

Correct answer: B

Rationale: The correct answer is B: Hot flashes. When initiating therapy with raloxifene, clients should be advised to monitor for hot flashes as they are a common adverse effect associated with this medication. Hot flashes are a well-known side effect of raloxifene due to its action on estrogen receptors. Leg cramps (Choice A), urinary frequency (Choice C), and hair loss (Choice D) are not typically associated with raloxifene therapy. Therefore, monitoring for hot flashes is crucial to manage and address this common side effect appropriately.

5. A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by affecting its metabolism. Echinacea, garlic, and ginseng are also known to interact with Warfarin, either by increasing the risk of bleeding or altering its anticoagulant effects. However, St. John's wort is particularly significant due to its potent enzyme-inducing properties that can lead to subtherapeutic levels of Warfarin, potentially increasing the risk of blood clots.

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