Nursing Elites

1. A client is prescribed diazepam for muscle spasms. What instruction should the nurse include in the client's teaching plan?

• A. Avoid drinking alcohol
• B. Take with food to avoid gastrointestinal upset
• C. Increase fluid intake
• D. Take medication with grapefruit juice

Correct answer: A

Rationale: The correct instruction for a client prescribed diazepam for muscle spasms is to avoid drinking alcohol. Diazepam can cause drowsiness and enhance the effects of alcohol, leading to increased sedation and impaired cognitive function. Clients should be advised to avoid alcohol consumption while taking diazepam to prevent these adverse effects and ensure their safety.

2. A client is receiving metronidazole for Clostridium difficile pseudomembranous colitis. Which information should the nurse include in this client's medication teaching plan?

• A. Drink adequate water daily
• B. Take with food
• C. Avoid alcohol consumption
• D. Store medication in the refrigerator

Correct answer: C

Rationale: The correct information to include in the medication teaching plan for a client receiving metronidazole for Clostridium difficile pseudomembranous colitis is to avoid alcohol consumption. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, leading to symptoms such as nausea, vomiting, flushing, and headache. Therefore, it is crucial for the client to abstain from alcohol while taking this medication to prevent adverse effects and ensure treatment effectiveness. Choices A, B, and D are incorrect. Drinking adequate water daily is a general health recommendation but not specific to metronidazole use. Taking with food is not necessary for metronidazole, and in fact, it is recommended to be taken on an empty stomach for better absorption. Storing the medication in the refrigerator is also incorrect, as metronidazole should be stored at room temperature.

3. What should be obtained prior to starting olanzapine for a male client with bipolar disorder?

• A. Complete blood count
• B. Family history of hypertension
• C. History of erectile dysfunction
• D. Baseline weight

Correct answer: D

Rationale: Baseline weight should be obtained prior to starting olanzapine in a male client with bipolar disorder to monitor for potential weight gain associated with the medication. Olanzapine is known to cause weight gain and monitoring the baseline weight can help in assessing any changes during treatment.

4. A client with a history of atrial fibrillation is prescribed apixaban. The nurse should monitor for which potential side effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Bleeding. Apixaban is an anticoagulant medication that works by decreasing the blood's ability to clot. One of the significant side effects of apixaban is an increased risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in the urine or stool, or unusual bleeding or bruising. Monitoring for these signs is crucial to prevent or manage any potential complications associated with the medication. Choices B, C, and D are incorrect because weight gain, headache, and nausea are not typically associated with apixaban use. Therefore, the nurse should primarily focus on monitoring for signs of bleeding in a client prescribed apixaban.

5. A home health care nurse observes that a client with Parkinson's syndrome is experiencing increased tremors and difficulty in movement. What should the nurse do in response to this finding?

• A. Report the observed finding to the healthcare provider right away
• B. Arrange a medical evaluation so the medication dose can be adjusted
• C. Schedule a return home visit in 2 weeks to monitor
• D. Explain that this is an expected progression of Parkinson's

Correct answer: B

Rationale: In a client with Parkinson's syndrome experiencing increased tremors and movement difficulty, arranging a medical evaluation is crucial to adjust the medication dose. This proactive approach helps in managing the symptoms effectively. Reporting the finding to the healthcare provider may delay necessary adjustments in treatment. Scheduling a return home visit in 2 weeks may not address the immediate need for medication adjustment. Explaining that the progression is expected without taking action does not address the client's worsening symptoms.

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