Nursing Elites

1. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of the medication. Dietary fiber can help maintain bowel regularity and alleviate constipation.

2. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?

• A. Insomnia
• B. Hypertension
• C. Bone marrow suppression
• D. Constipation

Correct answer: C

Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.

3. A healthcare professional is educating a client who has a new prescription for Vitamin B12 injections. Which of the following statements should the healthcare professional include?

• A. Take the medication with a full glass of water.
• B. You will need to take this medication for the rest of your life.
• C. Expect a metallic taste in your mouth.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is B: 'You will need to take this medication for the rest of your life.' Clients with conditions like pernicious anemia or other causes of vitamin B12 deficiency may require lifelong cyanocobalamin supplementation to prevent deficiency. This is because their bodies are unable to absorb B12 from dietary sources adequately, necessitating ongoing injections to maintain optimal B12 levels. Choices A, C, and D are incorrect. A full glass of water is not necessary for Vitamin B12 injections. Metallic taste in the mouth is not a common side effect of Vitamin B12 injections, and there is no need to avoid consuming dairy products specifically in relation to Vitamin B12 injections.

4. What is the therapeutic class of Valproate?

• A. Anticoagulant
• B. Antianxiety, benzodiazepines
• C. Anticonvulsant, vascular headache suppressant
• D. Mood stabilizer

Correct answer: C

Rationale: Valproate belongs to the therapeutic class of anticonvulsants. It is primarily used to manage seizures but is also effective in treating vascular headaches. Therefore, it is not classified as an anticoagulant, antianxiety medication, or mood stabilizer. Option A, anticoagulant, is incorrect as valproate does not have anticoagulant properties. Option B, antianxiety benzodiazepines, is incorrect as valproate is not primarily used to treat anxiety disorders with benzodiazepines. Option D, mood stabilizer, is incorrect as valproate is not classified as a mood stabilizer, although it can be used in some cases for mood disorders, its primary therapeutic class is anticonvulsant.

5. A client who has been taking prednisone to treat asthma is advised to discontinue the medication. The client should be instructed to reduce the dose gradually to prevent which of the following adverse effects?

• A. Hyperglycemia
• B. Adrenocortical insufficiency
• C. Severe dehydration
• D. Rebound pulmonary congestion

Correct answer: B

Rationale: Abruptly stopping prednisone can result in adrenocortical insufficiency due to suppression of the adrenal glands. Gradually tapering the dose helps the body adjust and resume its natural cortisol production, preventing adrenal insufficiency. Choice A, hyperglycemia, is a possible adverse effect of prednisone, but it is not the primary reason for gradual tapering. Severe dehydration (Choice C) and rebound pulmonary congestion (Choice D) are not typically associated with discontinuing prednisone.

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