Nursing Elites

1. A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in the client education related to this medication?

• A. This medication is prescribed for long-term therapy prophylaxis against anginal attacks
• B. Do not crush this medication
• C. Take the medication in the evening after dinner
• D. Do not take an additional tablet if you experience chest pain

Correct answer: A

Rationale: The correct answer is A because isosorbide mononitrate is used for long-term prophylaxis against anginal attacks. Choice B is incorrect because isosorbide mononitrate should not be crushed. Choice C does not specify a particular time for medication administration. Choice D is incorrect because isosorbide mononitrate is not meant to be taken as needed for chest pain; it is part of a long-term therapy plan.

2. A healthcare provider is preparing to administer bisacodyl suppository to a client. Which of the following actions should the healthcare provider take?

• A. Don sterile gloves
• B. Lubricate index finger
• C. Use a rectal applicator for insertion
• D. Position client supine with knees bent

Correct answer: B

Rationale: The correct action when administering a bisacodyl suppository is to lubricate the index finger for easier insertion. Using a rectal applicator for insertion is not recommended for bisacodyl suppositories. Positioning the client supine with knees bent is not necessary for the administration of a bisacodyl suppository. While wearing gloves is important for infection control, sterile gloves are not required for this procedure.

3. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

• A. Advise the client to take the medication once daily at bedtime
• B. This medication is for the acute management of asthma
• C. Avoid dairy products while taking this medication
• D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up

Correct answer: A

Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.

4. A nurse is reviewing the medication class benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients?

• A. A client with glaucoma
• B. A client with renal failure
• C. A client with hypertension
• D. A client with insomnia

Correct answer: A

Rationale: The correct answer is A. Benzodiazepines should be used cautiously in clients with glaucoma because these medications can increase intraocular pressure. Choices B, C, and D are incorrect because renal failure, hypertension, and insomnia are not contraindications for administering benzodiazepines.

5. A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?

• A. Stop the infusion
• B. Document the findings as a harmless reaction
• C. Slow the infusion rate
• D. Administer diphenhydramine

Correct answer: C

Rationale: The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.

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