Nursing Elites

1. A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select one that doesn't apply.

• A. Nizatidine (Axid)
• B. Ranitidine (Zantac)
• C. Famotidine (Pepcid)
• D. Ibuprofen (Motrin)

Correct answer: D

Rationale: H2-receptor antagonists like Nizatidine, Ranitidine, and Famotidine are used to suppress gastric acid secretion, relieve heartburn symptoms, and prevent complications of peptic ulcer disease. Ibuprofen, on the other hand, is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, but it is not an H2-receptor antagonist. It is essential to differentiate between these medication classes to ensure appropriate treatment for gastrointestinal conditions.

2. A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a child. How is this vaccine best administered?

• A. Intramuscularly in the deltoid muscle
• B. Subcutaneously in the gluteal muscle
• C. Subcutaneously in the outer aspect of the upper arm
• D. Intramuscularly in the anterolateral aspect of the thigh

Correct answer: C

Rationale: The MMR vaccine is best administered subcutaneously in the outer aspect of the upper arm. This route allows for proper absorption and efficacy of the vaccine while minimizing the risk of injury or discomfort to the child.

3. A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:

• A. Both are weak potassium-losing diuretics.
• B. The combination of these medications prevents renal toxicity.
• C. Hydrochlorothiazide is less expensive, so using a combination of diuretics is cost-effective.
• D. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

Correct answer: D

Rationale: The combination of triamterene and hydrochlorothiazide is used because triamterene is a potassium-sparing diuretic, which helps retain potassium, while hydrochlorothiazide is a potassium-losing diuretic, which promotes potassium excretion. This combination helps balance potassium levels in the body, preventing imbalances that can occur when using potassium-losing diuretics alone.

4. A client is being taught about the use of nitroglycerin (Nitrostat) for angina. Which statement by the client indicates a need for further teaching?

• A. I will sit or lie down when I take the medication.
• B. I can take up to three tablets, 5 minutes apart, if needed.
• C. I will call 911 if my chest pain is not relieved after taking three tablets.
• D. I will keep the medication in its original dark container.

Correct answer: B

Rationale: The correct administration of nitroglycerin for angina is to take up to three tablets, 5 minutes apart. If the chest pain persists after the third tablet, emergency medical services should be called. Taking more than three tablets or reducing the time interval between doses may lead to hypotension and indicates a need for further teaching.

5. A client is being educated about the use of sertraline (Zoloft) for depression. Which statement by the client indicates a need for further teaching?

• A. I should take the medication with a high-protein meal.
• B. I may experience dizziness when getting up quickly.
• C. I might notice a decrease in my sex drive.
• D. I should report any thoughts of self-harm to my healthcare provider.

Correct answer: A

Rationale: The statement 'I should take the medication with a high-protein meal' indicates a need for further teaching as sertraline (Zoloft) should not be taken with a high-protein meal due to potential interference with medication absorption. Choices B, C, and D are correct statements associated with the use of sertraline for depression. It is common to experience dizziness when quickly getting up, notice a decrease in sex drive, and important to report any thoughts of self-harm to the healthcare provider while on this medication.

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