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 to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication over 5 minutes.
• B. Administer a dose of Naloxone prior to giving the Hydromorphone.
• C. Assess the client's blood pressure prior to administration.
• D. Inject the medication into the client's subcutaneous tissue.

Correct answer: A

Rationale: The healthcare professional should administer IV Hydromorphone slowly over 5 minutes to reduce the risk of hypotension and respiratory depression. Rapid administration can lead to adverse effects due to its potency. Choice B is incorrect because Naloxone is used as an antidote for opioid overdose, not routinely administered with Hydromorphone. Choice C is important but not specific to the administration of Hydromorphone. Choice D is incorrect as Hydromorphone is intended for intravenous use, not subcutaneous injection.

3. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each day, usually at bedtime, to prevent tolerance. This practice allows for a nitrate-free interval, reducing the risk of developing tolerance to the medication. Applying the patch to a different site each day (choice A) is not necessary as long as the skin is clean and rotated to avoid skin irritation. Applying the patch over an area with little or no hair (choice C) does not impact the effectiveness of the medication. Keeping the patch on for 24 hours at a time (choice D) can lead to tolerance, which is why the patch should be removed daily.

4. A client is taking Sucralfate PO for Peptic Ulcer Disease and 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 timing helps to ensure adequate absorption and effectiveness of both medications without compromising therapeutic outcomes. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, and chewing sucralfate thoroughly before swallowing do not address the need for a 2-hour interval between these medications to prevent interference with phenytoin absorption.

5. What should you assess for in a patient who is on Valproate?

• A. Suicidal thoughts
• B. Monitor for seizures
• C. Bipolar disorder
• D. Migraines

Correct answer: A

Rationale: The correct answer is A: Suicidal thoughts. When a patient is prescribed Valproate, it is crucial to assess for suicidal thoughts as it is a serious side effect associated with this medication. Valproate has been linked to an increased risk of suicidal ideation and behavior, particularly in patients with epilepsy or bipolar disorder. Monitoring for signs of depression or changes in behavior is essential to ensure patient safety and well-being. Choices B, C, and D are incorrect because while monitoring for seizures, managing bipolar disorder, and treating migraines are also important considerations when a patient is on Valproate, assessing for suicidal thoughts takes priority due to the serious nature of this potential side effect.

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