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. When educating a client with a new prescription for albuterol, which instruction should the nurse include?

• A. Use the inhaler every 4 hours.
• B. Shake the inhaler before use.
• C. Take a deep breath before inhaling the medication.
• D. Use a spacer when using the inhaler.

Correct answer: B

Rationale: Shaking the albuterol inhaler before use is essential to ensure that the medication is evenly mixed and properly delivered when inhaled. This maximizes the effectiveness of the medication in opening the airways and relieving symptoms of bronchospasm.

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

• A. Take this medication with milk.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication with antacids.

Correct answer: B

Rationale: The correct answer is B: 'Take this medication on an empty stomach.' Ferrous sulfate is best absorbed on an empty stomach. Instruct the client to take it 1 hour before or 2 hours after meals to maximize absorption and avoid interactions with food or beverages that may decrease absorption. Choice A is incorrect because taking Ferrous sulfate with milk can decrease its absorption. Choice C is incorrect as there is no specific benefit to taking it before bedtime. Choice D is incorrect as antacids can interfere with the absorption of Ferrous sulfate.

4. When teaching a client who has a new prescription for Dextromethorphan to suppress a cough, which adverse effect should the nurse instruct the client to monitor for?

• A. Diarrhea
• B. Anxiety
• C. Sedation
• D. Palpitations

Correct answer: C

Rationale: The correct answer is C: Sedation. Dextromethorphan can cause sedation, so the client should be advised to avoid activities that require alertness. Diarrhea, anxiety, and palpitations are not commonly associated adverse effects of Dextromethorphan.

5. A child is prescribed Amoxicillin 20 mg/kg/day PO to be administered every 12 hr. The child weighs 44 lb. The available medication is amoxicillin suspension 250 mg/5 mL. How many mL should be given per dose?

• A. 4 mL
• B. 5 mL
• C. 6 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage per administration: Convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the nurse should administer 4 mL of amoxicillin suspension per dose. Choice B, 5 mL, is incorrect because the calculation shows that 4 mL is the correct dose. Choices C and D are also incorrect as they are not in line with the calculated dosage based on the weight of the child and the concentration of the medication.

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