Nursing Elites

1. What instruction should the nurse include in this patient's health education regarding chloroquine phosphate (Aralen) for malaria prophylaxis?

• A. “Take your pill on the same day each week.”
• B. “Watch out for any unusual rash on your trunk and arms, but this isn't cause for concern.”
• C. “Remember to take your chloroquine on an empty stomach.”
• D. “We'll provide you with enough syringes and teach you how to inject the drug.”

Correct answer: A

Rationale: The correct instruction for the nurse to include in this patient's health education regarding chloroquine phosphate (Aralen) for malaria prophylaxis is to “Take your pill on the same day each week.” This is essential because chloroquine is typically taken once a week on the same day to ensure consistent protection against malaria. Choice B is incorrect because while rashes are a possible side effect of chloroquine, they are not a usual occurrence and should be reported to the healthcare provider. Choice C is incorrect because chloroquine does not need to be taken on an empty stomach. Choice D is incorrect as chloroquine is typically administered orally, not by injection.

2. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse include in the patient teaching?

• A. Take the medication with food to prevent nausea.
• B. Take the medication at the same time each day to maintain consistent hormone levels.
• C. Avoid prolonged sun exposure while taking this medication.
• D. Discontinue the medication if side effects occur.

Correct answer: B

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This is crucial for the drug to work optimally. Choice A is incorrect because medroxyprogesterone acetate does not necessarily need to be taken with food to prevent nausea. Choice C is not directly related to the medication's administration and is not a common teaching point for this drug. Choice D is incorrect as discontinuing the medication abruptly can lead to adverse effects and is not recommended without consulting a healthcare provider.

3. Right-sided heart failure is characterized by:

• A. Immunosuppression
• B. Pulmonary edema
• C. Peripheral edema
• D. Coughing

Correct answer: C

Rationale: Right-sided heart failure is characterized by peripheral edema, which results from the buildup of fluid in the body. This fluid accumulates in the extremities due to the heart's inability to effectively pump blood forward. Choices A, B, and D are incorrect. Immunosuppression is not a typical feature of right-sided heart failure. Pulmonary edema is more commonly associated with left-sided heart failure, where fluid accumulates in the lungs. Coughing is a symptom that can be present in various conditions but is not a defining characteristic of right-sided heart failure.

4. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse provide during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may decrease the risk of osteoporosis, so adequate calcium intake is important.
• C. Tamoxifen may cause weight gain, so patients should monitor their diet.
• D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: When a patient is prescribed tamoxifen, a critical piece of information that the nurse should provide during patient education is that tamoxifen may increase the risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as weight gain is a possible side effect of tamoxifen, but it is not a critical piece of information compared to the risk of venous thromboembolism. Choice D is incorrect because tamoxifen is actually used to treat breast cancer, not increase its risk.

5. A patient is taking alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication at bedtime to ensure absorption during sleep.
• C. Take the medication with milk to enhance calcium absorption.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication at bedtime (choice B) is not recommended as it can lead to esophageal irritation when lying down. Taking the medication with milk (choice C) is incorrect as it may interfere with the absorption of alendronate. Taking the medication with food (choice D) is not recommended as it may reduce the effectiveness of the medication.

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