Nursing Elites

1. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

2. A healthcare professional is caring for an older adult client who has a new prescription for Digoxin and takes multiple other medications. Which of the following medications, when used concurrently with Digoxin, places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to Digoxin toxicity. When these medications are used together, the client is at an increased risk. Phenytoin (Choice A) does not significantly impact digoxin levels. Warfarin (Choice C) and aluminum hydroxide (Choice D) do not directly increase the risk of Digoxin toxicity. Therefore, the correct choice is Verapamil (Choice B) due to its potential to raise digoxin levels and cause toxicity.

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

• A. Notify the provider if you plan to become pregnant.
• B. Take the medication 1 hr before you plan to go to sleep.
• C. Allow at least 6 hr for sleep when taking Zolpidem.
• D. To increase the effectiveness of Zolpidem, take it with a bedtime snack.

Correct answer: A

Rationale: Zolpidem is classified under Pregnancy Risk Category C. It is essential for the client to inform the provider if she plans to become pregnant as Zolpidem use during pregnancy may pose risks to the fetus. This precaution allows for appropriate assessment and possible adjustments to the treatment plan to ensure the safety of both the client and the developing baby. Choice B is incorrect because Zolpidem is usually taken immediately before bedtime, not 1 hour before. Choice C is incorrect as Zolpidem is known for its quick onset of action, and the client does not need to allocate a specific amount of time for sleep. Choice D is incorrect as taking Zolpidem with food, especially a bedtime snack, may delay its onset of action.

4. A client has a prescription for Trimethoprim-Sulfamethoxazole. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Increase fluid intake.
• C. Expect reddish-orange urine.
• D. Avoid high-protein foods.

Correct answer: B

Rationale: The correct instruction for a client prescribed Trimethoprim-Sulfamethoxazole is to increase fluid intake. This helps prevent crystalluria and kidney stones, which are potential adverse effects of this medication. Adequate hydration is essential to reduce the risk of these complications.

5. When teaching a client who has a prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Monitor for a persistent cough.
• C. Expect to have increased appetite.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Monitor for a persistent cough.' Lisinopril, an ACE inhibitor, can cause a persistent dry cough as a side effect. It is essential for the client to report this symptom to their healthcare provider for further evaluation and management. Choice A is incorrect because Lisinopril is typically taken in the morning. Choice C is incorrect as Lisinopril is not known to cause increased appetite. Choice D is also incorrect as Lisinopril can lead to increased potassium levels in the blood, so avoiding foods high in potassium is not necessary.

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