Nursing Elites

1. A client has a new prescription for Methotrexate to treat Rheumatoid Arthritis. Which of the following instructions should the nurse provide?

• A. Take this medication with food to prevent nausea.
• B. Drink plenty of fluids to stay hydrated while on this medication.
• C. Avoid alcohol while taking this medication.
• D. Wear sunscreen when outdoors while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client taking Methotrexate is to avoid alcohol, as it can increase the risk of liver damage. Alcohol consumption should be avoided to prevent potential adverse effects while on this medication.

2. When teaching parents of a school-age child about transdermal Methylphenidate, which instruction should the nurse include?

• A. Apply one patch once per day.
• B. Leave the patch on for 9 hours.
• C. Apply the patch to the child's waistline.
• D. Use the opened tray within 6 months.

Correct answer: B

Rationale: When administering transdermal Methylphenidate, the patch should be left on for 9 hours per day to ensure optimal absorption and effectiveness of the medication. This duration helps maintain a consistent level of the drug in the child's system. Incorrect options: A) Applying one patch once per day is not the correct dosing regimen for transdermal Methylphenidate. C) The patch should not be applied to the child's waistline as it is recommended to apply it to a clean, dry area. D) Using the opened tray within 6 months is not directly related to the administration of transdermal Methylphenidate.

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

• A. Take this medication with food.
• B. Avoid eating foods high in potassium.
• C. Take this medication at bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct instruction for taking Metformin is to take it with food. This helps reduce gastrointestinal side effects and ensures better absorption of the medication. Choice B is incorrect as there is no specific need to avoid foods high in potassium when taking Metformin. Choice C is incorrect because Metformin is usually taken with meals, not at bedtime. Choice D is incorrect as Metformin is typically taken daily, not every other day.

4. A healthcare professional is caring for a group of clients receiving antimicrobial therapy. Which of the following clients should the professional plan to monitor for manifestations of antibiotic toxicity?

• A. An adolescent client with a sinus infection
• B. An older adult client with prostatitis
• C. A client who is postpartum with mastitis
• D. A middle-aged client with a urinary tract infection

Correct answer: B

Rationale: An older adult client with prostatitis who is receiving antibiotics should be monitored for toxicity due to age-related reductions in medication metabolism and excretion. Older adults are more susceptible to antibiotic toxicity, making them a high-risk group for adverse effects.

5. A client has a new prescription for Alteplase. Which of the following actions should the nurse plan to take?

• A. Administer the medication within 4 hours of the onset of symptoms.
• B. Reconstitute the medication with sterile saline.
• C. Administer heparin concurrently with the Alteplase infusion.
• D. Monitor for changes in level of consciousness.

Correct answer: D

Rationale: Alteplase is a thrombolytic agent used to dissolve blood clots. Patients receiving Alteplase are at risk for bleeding complications, including intracranial bleeding. Monitoring for changes in the level of consciousness is crucial as it can indicate early signs of bleeding, such as increased intracranial pressure. This rapid assessment allows for timely intervention and prevention of further complications. Choices A, B, and C are incorrect. Administering Alteplase within 4 hours of symptom onset is related to the time-sensitive nature of thrombolytic therapy for conditions like acute myocardial infarction or ischemic stroke. Reconstituting Alteplase with sterile saline is a correct step in preparing the medication for administration. Administering heparin concurrently with Alteplase is generally avoided due to the increased risk of bleeding.

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