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 caring for a client who has a new prescription for Digoxin. Which of the following findings should the healthcare provider identify as a potential sign of Digoxin toxicity?

• A. Nausea
• B. Dry mouth
• C. Hypoglycemia
• D. Tinnitus

Correct answer: A

Rationale: Nausea is a potential sign of Digoxin toxicity. Along with vomiting, visual disturbances, and confusion, it can be an early indication of an overdose. Dry mouth is not typically associated with Digoxin toxicity. Hypoglycemia is a low blood sugar level and is not directly related to Digoxin toxicity. Tinnitus, a ringing in the ears, is not a common sign of Digoxin toxicity. Healthcare providers should closely monitor clients on Digoxin for symptoms like nausea to prevent serious complications.

3. A client is taking Propylthiouracil. For which of the following adverse effects of this medication should the nurse monitor?

• A. Bradycardia
• B. Insomnia
• C. Heat intolerance
• D. Weight loss

Correct answer: A

Rationale: Propylthiouracil is a medication used to treat hyperthyroidism. One of the adverse effects of Propylthiouracil is bradycardia, which is a slower than normal heart rate. Since the medication works by decreasing thyroid hormone production, it can lead to hypothyroidism as a side effect, causing bradycardia. Therefore, the nurse should monitor the client for signs and symptoms of bradycardia while taking Propylthiouracil. Choices B, C, and D are incorrect because insomnia, heat intolerance, and weight loss are not typically associated adverse effects of Propylthiouracil.

4. A client has a new prescription for Timolol. How should the nurse instruct the client to insert eye drops?

• A. Press your finger on the inside corner of your eye for 1 minute after application.
• B. Apply the eye drops directly to the cornea.
• C. Drop the prescribed amount of medication into the center of the conjunctival sac.
• D. Wipe your eyes gently with a tissue immediately after application.

Correct answer: C

Rationale: When administering eye drops, it is essential to instruct the client to drop the prescribed amount of medication into the center of the conjunctival sac. This technique helps ensure proper distribution of the medication and reduces the risk of potential adverse effects. Pressing on the inside corner of the eye is done to prevent systemic absorption, applying drops directly to the cornea can cause irritation, and wiping the eyes after application can lead to decreased effectiveness of the medication.

5. A client has a new prescription for Diltiazem. Which of the following statements should the nurse include in the teaching?

• A. This medication may cause dry mouth.
• B. You should avoid drinking grapefruit juice.
• C. You may experience a rapid heart rate.
• D. Increase your intake of fiber-rich foods.

Correct answer: B

Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.

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