Nursing Elites

1. A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?

• A. NSAIDs
• B. Cardiac glycosides
• C. Beta blockers
• D. None of the above

Correct answer: C

Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.

2. 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 instruction for the nurse to include when teaching a client with OCD who has a new prescription for Paroxetine is that it can take several weeks before the client feels like the medication is helping. Paroxetine, like other selective serotonin reuptake inhibitors (SSRIs), can take 1 to 4 weeks before the client reaches the full therapeutic benefit. Therefore, it is important to inform the client about this delay in onset of action to manage their expectations and promote adherence to the treatment plan. Choices B, C, and D are incorrect because taking Paroxetine before bedtime is not necessary, it should be taken consistently at the same time each day; Paroxetine is usually taken regularly, not as needed; and while monitoring weight is important, it is not a specific instruction related to the onset of action for Paroxetine.

3. A client is admitted for a surgical procedure. Which preexisting condition can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine can produce psychological effects like hallucinations. Patients with schizophrenia may be more prone to experiencing exacerbation of their symptoms when exposed to Ketamine due to its potential to worsen psychotic symptoms. Therefore, schizophrenia can be a contraindication for the use of Ketamine as an anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for the use of Ketamine.

4. A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?

• A. Apply the patch to a hairless area of the body.
• B. Remove the patch every 12 hours.
• C. Massage the patch after applying it.
• D. Place the patch over a hairless area of the body.

Correct answer: D

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.

5. While teaching a client starting therapy with rituximab, which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The correct answer is B: Fever. The nurse should instruct the client to report fever as it can be an indication of an infection, which is a potential complication of rituximab therapy. Monitoring for fever is crucial to promptly address any signs of infection and ensure the client's safety during treatment. Choices A, C, and D are not typically associated with rituximab therapy and are less likely to be directly related to a serious complication requiring immediate attention.

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