Nursing Elites

1. A healthcare professional in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?

• A. Isosorbide
• B. Phenytoin
• C. Metronidazole
• D. Prednisone

Correct answer: A

Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Isosorbide is a nitrate that can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Therefore, it is essential to avoid concurrent use of isosorbide and sildenafil to prevent adverse effects. Phenytoin, metronidazole, and prednisone do not have significant interactions with sildenafil and are not contraindicated when used together.

2. A healthcare provider is providing teaching to a client who is starting therapy with paclitaxel. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Bradycardia
• B. Diarrhea
• C. Neutropenia
• D. Urinary retention

Correct answer: C

Rationale: The correct answer is C: Neutropenia. Paclitaxel commonly causes neutropenia due to bone marrow suppression. It is essential for clients receiving this medication to monitor for signs of neutropenia, such as fever, chills, and increased susceptibility to infections, as it can increase the risk of serious complications.

3. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

4. A nurse is teaching a client who has a new prescription for Prednisone. Which of the following instructions should the nurse include?

• A. Increase your intake of vitamin
• B. Take this medication on an empty stomach.
• C. Avoid drinking grapefruit juice.
• D. Take this medication every other day.

Correct answer: A

Rationale: Prednisone can lead to bone loss, so clients should increase their intake of vitamin D and calcium to help maintain bone health.

5. A client with increased liver enzymes is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

• A. Glucosamine
• B. Saw palmetto
• C. Kava
• D. St. John's wort

Correct answer: C

Rationale: Chronic use or high doses of kava have been associated with liver damage, including severe liver failure. Therefore, the nurse should report the client's use of kava to the healthcare provider for further evaluation and management.

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