Nursing Elites

1. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Paroxetine, an antidepressant commonly used for OCD, typically takes 1 to 4 weeks before the client experiences the full therapeutic benefit. Therefore, informing the client that it may take several weeks before feeling the medication's effects is crucial to manage expectations and ensure compliance with the treatment plan. Choice B is incorrect because Paroxetine is usually taken in the morning due to its activating effects and may cause insomnia if taken before bedtime. Choice C is incorrect because Paroxetine should be taken regularly as prescribed, not just when experiencing obsessive urges. Choice D is incorrect because although weight gain can be a side effect of Paroxetine, it is not a priority instruction compared to the delayed onset of therapeutic effects.

2. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

3. A client has a new prescription for Ondansetron for nausea and vomiting associated with chemotherapy. Which of the following statements should the nurse include?

• A. Take this medication one hour before chemotherapy.
• B. You may experience a headache while taking this medication.
• C. Increase your intake of potassium while taking this medication.
• D. This medication may cause temporary hearing loss.

Correct answer: B

Rationale: The correct statement the nurse should include is that the client may experience a headache while taking Ondansetron. Headache is a common side effect of this medication, and clients need to be informed about this potential adverse reaction to enhance their understanding and management of side effects. The other statements are incorrect because Ondansetron is usually taken 30 minutes before chemotherapy, not one hour before (choice A). There is no specific need to increase potassium intake while taking Ondansetron (choice C), and temporary hearing loss is not a common side effect associated with this medication (choice D).

4. A client is prescribed Clopidogrel. Which of the following laboratory values should the nurse monitor to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation. Therefore, the nurse should monitor the client's platelet count to assess for potential bleeding complications. Changes in platelet count can indicate the effectiveness of Clopidogrel therapy and help prevent adverse effects related to clotting or bleeding. Monitoring white blood cell count, hemoglobin, or blood glucose levels is not directly related to the action or side effects of Clopidogrel.

5. A healthcare professional is preparing to administer IV Furosemide to a client with heart failure. Which of the following actions should the healthcare professional take?

• A. Administer the medication undiluted.
• B. Dilute the medication with normal saline.
• C. Administer the medication through a central line.
• D. Administer the medication slowly over 2 minutes.

Correct answer: D

Rationale: Furosemide, when administered intravenously, should be given slowly over 2 minutes to reduce the risk of ototoxicity, a known adverse effect of rapid infusion. This method allows for better monitoring of the client's response and decreases the likelihood of adverse reactions associated with a faster administration rate.

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