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 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.

3. A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?

• A. I will avoid potassium-rich foods.
• B. I will not use a salt substitute.
• C. I will monitor my weight daily.
• D. I will increase my fluid intake as prescribed.

Correct answer: A

Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.

4. A client has begun therapy with theophylline (Theo-24). The nurse tells the client to limit the intake of which of the following while taking this medication?

• A. Oranges and pineapple
• B. Coffee, cola, and chocolate
• C. Oysters, lobster, and shrimp
• D. Cottage cheese, cream cheese, and dairy creamers

Correct answer: B

Rationale: Theophylline is a xanthine bronchodilator. Xanthines are found in coffee, cola, and chocolate. These foods should be limited while taking theophylline to prevent potential drug interactions or adverse effects.

5. The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:

• A. Take the medication with food.
• B. Increase fluid intake to 2000 to 3000 mL daily.
• C. Decrease sodium intake while taking the medication.
• D. Increase potassium intake while taking the medication.

Correct answer: B

Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.

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