Nursing Elites

1. A client with peptic ulcer disease is prescribed ranitidine (Zantac). Which statement by the client indicates the need for further teaching?

• A. I will take this medication at bedtime.
• B. I need to avoid smoking while taking this medication.
• C. I should take this medication with meals.
• D. This medication will help reduce stomach acid.

Correct answer: C

Rationale: The client's statement that they should take ranitidine with meals indicates a need for further teaching. Ranitidine is typically taken at bedtime or before meals to be most effective in reducing stomach acid. Taking it with meals may not provide the optimal therapeutic effect.

2. A patient with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. What is the primary action of this medication?

• A. Reduce inflammation
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Ipratropium is an anticholinergic bronchodilator that primarily works to relieve bronchospasm by dilating the airways and improving airflow in patients with COPD. It does not have a significant effect on reducing inflammation, suppressing cough, or thinning respiratory secretions.

3. A client with liver cirrhosis is being educated about managing their condition. Which statement by the client indicates a need for further teaching?

• A. I will avoid drinking alcohol
• B. I need to limit my salt intake
• C. I can take acetaminophen for pain
• D. I should eat a balanced diet

Correct answer: C

Rationale: The correct answer is C. Clients with liver cirrhosis should avoid acetaminophen because it can cause further liver damage. Acetaminophen is metabolized in the liver, and in individuals with liver disease, it can lead to liver toxicity. Therefore, clients with liver cirrhosis should use alternative pain medications that do not affect the liver, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids as prescribed by their healthcare provider. Choices A, B, and D are correct statements for managing liver cirrhosis. Avoiding alcohol helps prevent further liver damage, limiting salt intake helps manage fluid retention and complications like ascites, and eating a balanced diet supports overall health and helps prevent malnutrition.

4. A patient who is receiving chemotherapy for breast cancer develops thrombocytopenia. What should the nurse include in the care plan?

• A. Encourage light exercise.
• B. Avoid intramuscular injections.
• C. Do not administer aspirin.
• D. Use a soft toothbrush for oral care.

Correct answer: B

Rationale: Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. To minimize this risk, patients with thrombocytopenia should avoid activities that can cause injury or bleeding, such as intramuscular injections. Encouraging light exercise can be beneficial, as it promotes circulation without increasing the risk of trauma. However, avoiding intramuscular injections is crucial to prevent bleeding episodes. Aspirin should be avoided as it can further impair platelet function, exacerbating the condition. Using a soft toothbrush for oral care is recommended to prevent gum bleeding in patients with thrombocytopenia.

5. A patient with bipolar disorder is prescribed valproic acid. What is an important side effect for the nurse to monitor?

• A. Hypertension
• B. Liver toxicity
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Liver toxicity. Valproic acid is known to potentially cause liver toxicity. Monitoring liver function tests regularly in patients taking valproic acid is crucial to detect any signs of liver damage early and prevent serious complications.

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