Nursing Elites

1. A client with Peptic Ulcer Disease who is taking Sucralfate PO has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

• A. Take an antacid with the sucralfate.
• B. Take sucralfate with a glass of milk.
• C. Allow a 2-hour interval between these medications.
• D. Chew the sucralfate thoroughly before swallowing.

Correct answer: C

Rationale: Sucralfate can interfere with the absorption of phenytoin. To prevent this interaction, the client should allow a 2-hour interval between taking sucralfate and phenytoin. This interval helps ensure that each medication is absorbed effectively without affecting the other's absorption. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, or chewing sucralfate thoroughly before swallowing are not necessary or recommended instructions to prevent the interaction between sucralfate and phenytoin.

2. A healthcare professional is preparing a client's medications. Which of the following actions should the professional take to follow legal practice guidelines? (Select all that apply.)

• A. Maintain skill competency.
• B. Determine the dosage.
• C. Monitor for adverse effects.
• D. Safeguard medications.

Correct answer: A

Rationale: Maintaining skill competency is a critical aspect of legal practice guidelines for healthcare professionals. It is essential to ensure that healthcare professionals are competent and up-to-date with their skills to provide safe and effective care to patients. While determining the dosage, monitoring for adverse effects, and safeguarding medications are important aspects of medication administration, maintaining skill competency is a fundamental legal responsibility that ensures the delivery of quality care. Determining the dosage and monitoring for adverse effects are clinical responsibilities, while safeguarding medications pertains to proper storage and handling, not specifically related to legal practice guidelines.

3. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

4. When administering the drug senna to a patient, what must a health care provider inform the patient of?

• A. This drug is intended to lower blood pressure and is best used in combination with other antihypertensives
• B. This drug is not intended for long-term use
• C. The patient must limit his/her fiber intake
• D. Advise the patient to change positions slowly to limit the risk of orthostatic hypotension

Correct answer: B

Rationale: The correct answer is B. Senna is a laxative used for short-term relief of constipation, not for long-term use. Choice A is incorrect because senna does not lower blood pressure or require combination with antihypertensives. Choice C is unrelated as there is no need to limit fiber intake with senna. Choice D is incorrect as orthostatic hypotension is not a common concern with senna use.

5. A client who is withdrawing from alcohol has been prescribed Propranolol. Which information should the nurse include in the teaching?

• A. Increases the risk for seizure activity.
• B. Provides a form of aversion therapy.
• C. Decreases cravings.
• D. Results in mild hypertension.

Correct answer: C

Rationale: The correct information the nurse should include in the teaching is that Propranolol decreases cravings for alcohol. Propranolol is used as an adjunct medication during alcohol withdrawal to help reduce the desire for alcohol. Choice A is incorrect as Propranolol does not increase the risk for seizure activity; it can actually be used to prevent alcohol withdrawal seizures. Choice B is also incorrect as Propranolol does not provide aversion therapy. Choice D is incorrect as Propranolol is not known to result in mild hypertension.

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