Nursing Elites

1. A client has a new prescription for Alendronate to treat osteoporosis. Which of the following instructions should the nurse include?

• A. Take the medication with a full glass of water after rising in the morning.
• B. Lie down for at least 30 minutes after taking the medication.
• C. Take the medication before bedtime to reduce the risk of esophageal irritation.
• D. Crush the tablet and mix it with applesauce if having difficulty swallowing.

Correct answer: A

Rationale: The correct instruction is to take Alendronate with a full glass of water after rising in the morning. This helps reduce the risk of esophageal irritation, as the medication can cause irritation if not taken correctly. Taking it before bedtime (choice C) can increase the risk of irritation as the individual lies down. Lying down after taking the medication (choice B) can also lead to esophageal irritation. Crushing the tablet (choice D) is not recommended as Alendronate should be taken whole with a full glass of water.

2. A client is taking Glipizide to treat Diabetes Mellitus. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of this medication?

• A. Cholesterol level.
• B. Hematocrit.
• C. Blood glucose level.
• D. Calcium level.

Correct answer: C

Rationale: The correct answer is C: Blood glucose level. Monitoring the client's blood glucose level is crucial when taking Glipizide, a medication used to lower blood glucose levels in individuals with Diabetes Mellitus. By monitoring the blood glucose level, the nurse can evaluate the effectiveness of the medication in managing the client's condition. Choices A, B, and D are incorrect as they are not directly related to assessing the effectiveness of Glipizide in treating Diabetes Mellitus. Cholesterol level, hematocrit, and calcium level may be important for other aspects of the client's health but are not the primary indicators of Glipizide's effectiveness.

3. A healthcare professional is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare professional plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 min.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hr of manifestation onset.

Correct answer: B

Rationale: The correct intervention when administering IV Alteplase is to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This helps prevent bleeding complications associated with thrombolytic therapy. Administering IM Enoxaparin is not indicated with Alteplase, as it is an anticoagulant rather than a thrombolytic agent. Aminocaproic acid is not typically administered prior to alteplase infusion in the context of a massive Pulmonary Embolism. While timely administration of Alteplase is important, the specific timeframe within which it should be administered may vary based on the clinical situation, so a strict 8-hour window is not universally applicable.

4. When providing teaching to a client with a prescription for Hydrochlorothiazide, which instruction should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct instruction for a client prescribed Hydrochlorothiazide is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalance, potentially causing dehydration. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. Therefore, it is essential for the client to be vigilant in recognizing these symptoms and seek medical attention if they occur. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide at bedtime is not a specific instruction related to its effects or side effects. Avoiding foods high in potassium may be necessary for some medications, but it is not the primary concern with Hydrochlorothiazide. Taking this medication on an empty stomach is not a requirement and may vary depending on individual preferences or healthcare provider instructions.

5. A client has a new prescription for Filgrastim to treat neutropenia. Which of the following statements should the nurse include?

• A. This medication will help increase your white blood cell count.
• B. This medication will help reduce your risk of infection.
• C. This medication will help improve your red blood cell count.
• D. This medication will help increase your platelet count.

Correct answer: A

Rationale: The correct statement the nurse should include is that 'This medication will help increase your white blood cell count.' Filgrastim is a medication used to stimulate the production of white blood cells, specifically neutrophils, to increase the white blood cell count. This increase in white blood cells helps reduce the risk of infections in clients with neutropenia. Choices B, C, and D are incorrect because Filgrastim specifically targets white blood cells, not red blood cells or platelets.

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