Nursing Elites

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

• A. Avoid drinking alcohol while taking this medication.
• B. Take the medication with a high-fat meal.
• C. Expect increased hair growth.
• D. You should never stop taking the medication without consulting your healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client taking Methotrexate is to avoid drinking alcohol. Methotrexate can cause liver toxicity, and alcohol consumption can increase this risk. It is important to emphasize the avoidance of alcohol while on this medication to prevent adverse effects and ensure treatment effectiveness. The other options are incorrect: Taking Methotrexate with a high-fat meal is not necessary as it can be taken with or without food. Increased hair growth is not an expected effect of Methotrexate; in fact, hair loss is a potential side effect. Stopping the medication without consulting a healthcare provider can be dangerous and may lead to worsening of symptoms or relapse, making option D incorrect.

2. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)

• A. Expect therapeutic effects in 1-3 weeks.
• B. Discontinue the medication gradually under healthcare provider supervision.
• C. Change positions slowly to minimize dizziness.
• D. Increase dietary fiber intake to prevent constipation.

Correct answer: C

Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.

3. An older adult client has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias. The other choices, Phenytoin, Warfarin, and Aluminum hydroxide, do not significantly interact with Digoxin to cause toxicity. Phenytoin may reduce Digoxin levels, while Warfarin and Aluminum hydroxide have minimal interactions with Digoxin.

4. A client with breast cancer is receiving cyclophosphamide. What finding should the nurse monitor for?

• A. Hypertension
• B. Hyperglycemia
• C. Ototoxicity
• D. Hemorrhagic cystitis

Correct answer: D

Rationale: When a client is receiving cyclophosphamide, the nurse should monitor for hemorrhagic cystitis, a severe adverse effect caused by bladder irritation. It is essential to watch for signs such as hematuria, dysuria, and urinary frequency, and promptly intervene to prevent further complications. Hypertension (Choice A) is not typically associated with cyclophosphamide use. Hyperglycemia (Choice B) is not a common side effect of cyclophosphamide. Ototoxicity (Choice C) is more commonly associated with medications like aminoglycoside antibiotics or high-dose aspirin.

5. A drug ending in the suffix (azole) is considered a ______.

• A. H
• B. ACE inhibitor
• C. Antifungal
• D. Beta agonist

Correct answer: C

Rationale: Drugs ending in the suffix -azole are commonly associated with antifungal medications. Examples include fluconazole, ketoconazole, and itraconazole. These medications are used to treat fungal infections by inhibiting the growth of fungi. Therefore, the correct answer is option C, 'Antifungal'. Options A, B, and D do not accurately describe drugs ending in -azole.

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