Nursing Elites

1. A client has a new prescription for Furosemide. Which of the following dietary instructions should the nurse provide?

• A. Increase your intake of bananas and oranges.
• B. Limit your intake of calcium-rich foods.
• C. Avoid drinking milk.
• D. Increase your intake of green, leafy vegetables.

Correct answer: A

Rationale: The correct answer is A: 'Increase your intake of bananas and oranges.' Furosemide, a loop diuretic, can cause potassium loss leading to hypokalemia. To prevent this, clients should increase their intake of potassium-rich foods, such as bananas and oranges, to replenish potassium levels. Choices B, C, and D are incorrect because limiting calcium-rich foods or avoiding milk is not necessary with Furosemide, and increasing intake of green, leafy vegetables does not specifically address the potential potassium loss associated with this medication.

2. A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?

• A. Taking four medications decreases the risk of a severe allergic reaction.
• B. Taking four medications reduces the chance that the bacteria will become resistant.
• C. Taking four medications reduces the risk of adverse reactions.
• D. Taking four medications decreases the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: When treating tuberculosis, using a combination of multiple medications is crucial to reduce the risk of bacterial resistance. The use of four medications helps to target the bacteria from different angles, making it harder for them to develop resistance to the treatment. This approach is essential to ensure the effectiveness of the treatment regimen and to prevent the spread of drug-resistant strains of tuberculosis. Choices A, C, and D are incorrect because the primary reason for using multiple medications in tuberculosis treatment is to prevent the development of bacterial resistance, not to decrease the risk of allergic reactions, adverse reactions, or affecting the tuberculin skin test results.

3. A client receiving chemotherapy reports nausea and vomiting. Which of the following medications should the nurse anticipate administering?

• A. Ondansetron
• B. Metoclopramide
• C. Promethazine
• D. Lorazepam

Correct answer: A

Rationale: The correct answer is A: Ondansetron. Ondansetron is a commonly used antiemetic for managing nausea and vomiting in clients undergoing chemotherapy. It works by blocking serotonin to reduce these symptoms effectively. Metoclopramide (choice B) is another antiemetic but is more commonly used for gastric motility disorders. Promethazine (choice C) is an antihistamine with antiemetic properties, but ondansetron is often preferred for chemotherapy-induced nausea and vomiting due to its efficacy and fewer side effects. Lorazepam (choice D) is a benzodiazepine used for anxiety and insomnia, not typically for managing nausea and vomiting in this context.

4. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following herbal supplements should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism pathways, potentially leading to decreased anticoagulant effects. Therefore, clients on Warfarin therapy should avoid St. John's wort. While echinacea, garlic, and ginseng are also herbal supplements that can interact with Warfarin, St. John's wort is particularly known for its significant impact on Warfarin metabolism. Echinacea may increase the risk of bleeding when taken with Warfarin, garlic may potentiate the anticoagulant effects of Warfarin, and ginseng may also increase the risk of bleeding. However, St. John's wort is the most crucial to avoid due to its significant impact on Warfarin metabolism.

5. A client has a new prescription for Verapamil to treat angina. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of Verapamil?

• A. I am constipated frequently.
• B. I have been urinating more frequently.
• C. My skin is peeling.
• D. I have ringing in my ears.

Correct answer: A

Rationale: Constipation is a common adverse effect of Verapamil, a calcium channel blocker. Verapamil can slow down bowel movements and lead to constipation as a side effect. Therefore, the client reporting frequent constipation should alert the nurse to a potential adverse effect of Verapamil. Choices B, C, and D are not typically associated with Verapamil use. Increased urination is not a common side effect of Verapamil, peeling skin is more likely related to a dermatological issue, and ringing in the ears is not a known adverse effect of Verapamil.

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