Nursing Elites

1. A client has a new prescription for rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The nurse should instruct the client to report fever. Fever can be an indication of an infection, a potential complication of rituximab therapy. Monitoring and reporting fever promptly can help in early intervention to prevent further complications. Dizziness, urinary frequency, and dry mouth are not typically associated with rituximab therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings to report in this scenario.

2. A client has been prescribed Warfarin for atrial fibrillation. Which of the following instructions should the nurse include in the discharge teaching?

• A. Avoid foods high in vitamin K.
• B. Take this medication with food to prevent nausea.
• C. Monitor your heart rate daily before taking the medication.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for the nurse to include in the discharge teaching for a client prescribed Warfarin is to 'Avoid foods high in vitamin K.' Foods high in vitamin K can decrease the effectiveness of Warfarin by interfering with its anticoagulant effects, potentially leading to blood clotting issues. It is crucial for clients on Warfarin therapy to maintain a consistent intake of vitamin K-containing foods to ensure the stability of the medication's effects. Choices B, C, and D are incorrect because taking Warfarin with food, monitoring heart rate daily, or limiting fluid intake are not directly related to optimizing the effectiveness of Warfarin therapy.

3. A client is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?

• A. Light yellow urine
• B. Report of tinnitus
• C. Productive cough
• D. Blue-gray skin discoloration

Correct answer: D

Rationale: Blue-gray skin discoloration is a common sign of Amiodarone toxicity, known as blue-gray discoloration, which can affect areas like the face, neck, or hands. It is important to monitor for this side effect, as it can be a visible indicator of potential toxicity. Choices A, B, and C are incorrect. Light yellow urine is not typically associated with Amiodarone toxicity. Tinnitus is not a common manifestation of Amiodarone toxicity. A productive cough is not a recognized symptom of Amiodarone toxicity.

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

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

5. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• A. This medication can safely be taken during pregnancy.
• B. Eliminate grapefruit juice from your diet.
• C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
• D. Notify your provider if you develop a rash.

Correct answer: B

Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.

Similar Questions