Nursing Elites

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

• A. Take this medication with food.
• B. Avoid dairy products while taking this medication.
• C. Take this medication at bedtime.
• D. Increase your intake of vitamins.

Correct answer: A

Rationale: The correct instruction for a client prescribed Nitrofurantoin is to take the medication with food. Taking Nitrofurantoin with food helps enhance absorption and reduces the risk of gastrointestinal side effects. It is important for the nurse to emphasize this instruction to ensure the client benefits optimally from the medication. Choices B, C, and D are incorrect. Avoiding dairy products is not specifically required with Nitrofurantoin. Taking the medication at bedtime is not a standard instruction. Increasing vitamin intake is not necessary in relation to Nitrofurantoin therapy.

2. A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.

3. A client has a prescription for Erythromycin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Expect your urine to turn dark yellow.
• C. Take the medication with a full glass of milk.
• D. Report persistent diarrhea to your provider.

Correct answer: D

Rationale: The correct answer is D: 'Report persistent diarrhea to your provider.' Erythromycin is known to cause Clostridium difficile-associated diarrhea, which can be severe. Instructing the client to report any persistent diarrhea to their healthcare provider promptly is crucial to prevent complications. Choices A, B, and C are incorrect. Taking Erythromycin with food is generally recommended to reduce stomach upset, but it is not the most critical instruction. Expecting urine to turn dark yellow is not a common side effect of Erythromycin. Taking Erythromycin with a full glass of milk is not necessary and may not be appropriate for all clients, especially those with lactose intolerance or dairy allergies.

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

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct answer is to instruct the client to brush and floss their teeth regularly. Phenytoin can lead to gingival hyperplasia, making oral hygiene crucial to prevent complications. Encouraging good oral care practices helps reduce the risk of adverse effects on the gums and teeth. Avoiding grapefruit juice is not specifically related to Phenytoin. While some medications require intake with food, Phenytoin is usually taken on an empty stomach for better absorption. Increasing calcium-rich foods is not directly associated with Phenytoin therapy.

5. While providing an Angiotensin-converting enzyme (ACE) inhibitor, the patient asks what the action of the drug is. As a healthcare provider, you explain that the action of an ACE inhibitor is:

• A. To lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II
• B. To inhibit reabsorption of sodium back into the body, ultimately increasing urine output and lowering blood pressure
• C. To decrease heart rate and blood pressure by competing with Beta1 and Beta2 receptors in the heart and lungs
• D. To lower blood glucose by stimulating the release of insulin

Correct answer: A

Rationale: ACE inhibitors lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II. Angiotensin II is a potent vasoconstrictor, and by inhibiting its formation, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload on the heart. Choice B is incorrect as it describes the mechanism of action of diuretics, not ACE inhibitors. Choice C is incorrect as it refers to the action of beta-blockers, not ACE inhibitors. Choice D is incorrect as it describes the mechanism of action of antidiabetic medications, not ACE inhibitors.

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