Nursing Elites

1. A client has a new prescription for Lovastatin. Which of the following instructions should be included?

• A. Take this medication on an empty stomach.
• B. Take this medication in the morning.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: Lovastatin should be taken at bedtime because cholesterol production in the liver is highest at night, making the medication more effective in reducing cholesterol levels. By taking it at bedtime, the medication aligns with the body's natural rhythm of cholesterol synthesis, optimizing its therapeutic effects.

2. When teaching a client with cancer who has a prescription for methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Magnesium
• C. Vitamin D
• D. Iron

Correct answer: A

Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, so instructing the client to take folic acid helps reduce the risk of methotrexate toxicity by providing additional folic acid that the medication may deplete. Magnesium (choice B), Vitamin D (choice C), and Iron (choice D) are not the correct supplements to instruct the client to take with methotrexate.

3. What is the therapeutic use of Phenytoin?

• A. Replacement in hypothyroidism to restore normal hormonal balance
• B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
• C. Diminished seizure activity, termination of ventricular arrhythmias
• D. Prevention of thrombus formation, prevention of extension of existing thrombi

Correct answer: C

Rationale: Phenytoin is primarily used to diminish seizure activity and is effective in terminating ventricular arrhythmias. It works by stabilizing neuronal membranes, reducing repetitive neuronal firing, and limiting the spread of seizure activity in the brain. While phenytoin does not have a direct role in preventing thrombus formation or extending existing thrombi, it is crucial in managing seizures and certain arrhythmias.

4. A client is starting a course of Metronidazole to treat an infection. For which of the following adverse effects should the client stop taking Metronidazole and notify the provider?

• A. Metallic taste
• B. Nausea
• C. Ataxia
• D. Dark-colored urine

Correct answer: C

Rationale: The correct answer is C, 'Ataxia.' Ataxia is a sign of central nervous system (CNS) toxicity, which can be a severe adverse effect of Metronidazole. Metallic taste and nausea are common side effects of Metronidazole but do not require stopping the medication unless they persist or worsen. Dark-colored urine is not typically associated with Metronidazole and does not indicate a severe adverse effect.

5. Which of the following is not directly related to the drug toxicity of Ibuprofen?

• A. Nausea
• B. Renal dysfunction
• C. Anemia
• D. Muscle wasting

Correct answer: D

Rationale: Ibuprofen is known to cause adverse effects such as nausea, renal dysfunction, and anemia. However, muscle wasting is not a common toxicity associated with Ibuprofen use. Therefore, the correct answer is D.

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