Nursing Elites

1. A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:

• A. Avoid drinking alcohol.
• B. Report yellow eyes or skin immediately.
• C. Avoid Swiss or aged cheeses.
• D. Avoid vitamin supplements during therapy.

Correct answer: B

Rationale: When a client is on isoniazid (INH) therapy, they should be instructed to report any signs of hepatitis, such as yellowing of the eyes or skin, immediately. Alcohol consumption should be avoided during INH therapy due to the risk of hepatotoxicity. Foods high in tyramine, such as Swiss or aged cheeses, should also be avoided to prevent adverse reactions. Additionally, while on INH therapy, it is essential to avoid vitamin supplements containing pyridoxine (vitamin B6) to prevent potential interactions.

2. The healthcare provider should anticipate that the most likely medication to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder would be:

• A. Prednisone
• B. Sulfisoxazole
• C. Furosemide (Lasix)
• D. Intravenous immune globulin (IVIG)

Correct answer: B

Rationale: Children with spina bifida, especially those with a neurogenic bladder, are at an increased risk of urinary tract infections. Sulfisoxazole, an antibiotic, is commonly prescribed prophylactically to prevent UTIs in this population. Prednisone (Choice A) is a corticosteroid and is not typically used for prophylaxis in this scenario. Furosemide (Lasix) (Choice C) is a diuretic used to treat fluid retention and hypertension, not for preventing UTIs. Intravenous immune globulin (IVIG) (Choice D) is used to boost the immune system, not for UTI prophylaxis in this case.

3. A healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?

• A. Pancreatitis
• B. Pharyngitis
• C. Tonic-clonic seizures
• D. Human immunodeficiency virus (HIV) infection

Correct answer: D

Rationale: Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.

4. A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:

• A. Watch for irritability as a side effect.
• B. Take the tablet with a full glass of water.
• C. Take an extra dose if the cough is accompanied by fever.
• D. Crush the sustained-release tablet if immediate relief is needed.

Correct answer: B

Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.

5. Heparin sodium is prescribed for the client. The nurse expects that the healthcare provider will prescribe which of the following to monitor for a therapeutic effect of the medication?

• A. Hematocrit level
• B. Hemoglobin level
• C. Prothrombin time (PT)
• D. Activated partial thromboplastin time (aPTT)

Correct answer: D

Rationale: The correct answer is D, activated partial thromboplastin time (aPTT). Heparin affects the intrinsic pathway of coagulation. Monitoring aPTT helps ensure that heparin sodium is within the therapeutic range to prevent clot formation. Hematocrit and hemoglobin levels assess red blood cell concentrations and are not specific to monitoring heparin therapy. Prothrombin time (PT) is used to monitor the therapeutic effect of warfarin sodium, which affects the extrinsic pathway of coagulation, not heparin.

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