Nursing Elites

1. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

2. A healthcare professional is educating a client who is starting therapy with topotecan. Which of the following findings should the professional instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The correct answer is C: 'Sore throat.' Clients starting therapy with topotecan should be instructed to report a sore throat because it can indicate an infection due to the immunosuppressive effects of the medication. Infections can be serious in clients undergoing chemotherapy, so early detection and treatment are crucial to prevent complications. Choices A, B, and D are incorrect because while they are potential side effects of topotecan, they are usually not as immediately concerning as a sore throat, which could signal a serious infection requiring prompt attention.

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

• A. Expect to take this medication long-term.
• B. Increase fluid intake during therapy.
• C. Avoid sexual contact while on this medication.
• D. Consult your healthcare provider if you experience nausea.

Correct answer: B

Rationale: The correct instruction for a client taking Acyclovir is to increase fluid intake during therapy. Acyclovir can cause nephrotoxicity, potentially leading to kidney damage. Increasing fluid intake helps prevent this adverse effect by promoting adequate renal function and drug elimination. Choices A, C, and D are incorrect. Acyclovir is usually prescribed for short-term use, there is no need to avoid sexual contact while on the medication, and nausea is not a common side effect that necessitates immediate consultation with a healthcare provider.

4. When should a patient taking omeprazole be administered the medication?

• A. Before bedtime
• B. After dinner
• C. In the morning on an empty stomach
• D. With the patient's lunch meal

Correct answer: C

Rationale: Omeprazole should be administered in the morning on an empty stomach to maximize its effectiveness. This timing is important as omeprazole works best when taken before a meal to inhibit acid production by the stomach. Taking it on an empty stomach in the morning allows the medication to be absorbed efficiently and provides optimal therapeutic effects throughout the day. Choices A, B, and D are incorrect because taking omeprazole before bedtime, after dinner, or with lunch may not allow the medication to work effectively as it requires an empty stomach for better absorption and action.

5. A client has been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

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