Nursing Elites

1. 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.

2. A healthcare provider is preparing to administer metoprolol to a client. Which of the following findings should the provider identify as a contraindication to receiving this medication?

• A. Bradycardia
• B. Hypertension
• C. Fever
• D. Rash

Correct answer: A

Rationale: Metoprolol, a beta-blocker, is contraindicated in clients with bradycardia as it can further lower the heart rate, potentially leading to more serious complications. Bradycardia is defined as a heart rate below 60 beats per minute, and administering metoprolol in such cases can exacerbate this condition, causing adverse effects on cardiac output. Hypertension, fever, and rash are not contraindications for metoprolol administration.

3. A client reports taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: The correct answer is C, Warfarin. Aspirin increases the effect of anticoagulants like warfarin by inhibiting platelet aggregation, leading to an increased risk of bleeding. Therefore, the use of aspirin is generally contraindicated for clients taking warfarin. Choices A, B, and D are not contraindicated with aspirin. Digoxin, Metformin, and Nitroglycerin do not have significant interactions with Aspirin, unlike Warfarin, making them safe to use concomitantly.

4. When administering Lithium to a patient, what is a life-threatening side effect?

• A. Erythema
• B. Pancreatitis
• C. Seizures
• D. Headache

Correct answer: C

Rationale: When a patient is being treated with Lithium, a life-threatening side effect to watch out for is seizures. Lithium can lower the seizure threshold, increasing the risk of seizures. Seizures are serious and necessitate prompt medical intervention to ensure the patient's safety and well-being. Erythema, which is redness of the skin, is not a common life-threatening side effect of Lithium. Pancreatitis can be a side effect of Lithium, but it is not typically life-threatening. Headache is a common side effect of Lithium, but it is not considered life-threatening.

5. A healthcare professional is preparing to administer Belimumab for a client with Systemic Lupus Erythematosus. Which of the following actions should the healthcare professional plan to take?

• A. Warm the medication to room temperature before administering.
• B. Administer the medication by slow IV infusion over the recommended time frame.
• C. Dilute the medication in an appropriate solution as per manufacturer guidelines.
• D. Monitor the client for hypersensitivity reactions.

Correct answer: D

Rationale: The correct action the healthcare professional should plan to take when administering Belimumab is to monitor the client for hypersensitivity reactions. Belimumab is known to cause severe infusion reactions, including anaphylaxis in some cases. Monitoring for hypersensitivity reactions is crucial to detect and manage any adverse reactions promptly. Options A, B, and C are incorrect because warming the medication, administering by slow IV infusion, and dilution are not specific actions needed for Belimumab administration. The priority is to monitor the client for potential hypersensitivity reactions to ensure their safety.

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