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 healthcare provider is planning to administer Ciprofloxacin IV to a client who has cystitis. Which of the following actions should the healthcare provider take?

• A. Administer a concentrated solution.
• B. Infuse the medication over 60 min.
• C. Infuse the solution through the primary IV fluid tubing.
• D. Choose a small peripheral vein for administration.

Correct answer: B

Rationale: Ciprofloxacin should be infused over 60 minutes to minimize vein irritation and reduce the risk of adverse effects. Administering a concentrated solution can lead to vein irritation and potential complications. Infusing the solution through the primary IV fluid tubing can cause incompatibility issues. Choosing a small peripheral vein may not be suitable for administering Ciprofloxacin, which should be infused through a larger vein to prevent vein irritation and ensure a proper dilution of the medication.

3. A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?

• A. Varicella vaccine
• B. Rubella vaccine
• C. Inactivated influenza vaccine
• D. Measles vaccine

Correct answer: C

Rationale: The correct answer is C, the inactivated influenza vaccine. During pregnancy, the Centers for Disease Control and Prevention (CDC) recommend the inactivated influenza vaccine as safe for pregnant individuals. This vaccination is crucial to protect both the pregnant person and their developing baby from influenza-related complications. It is essential to avoid live vaccines, such as varicella (chickenpox), rubella, and measles vaccines during pregnancy due to the theoretical risk of harm to the fetus. Choices A, B, and D are incorrect because live vaccines are generally contraindicated during pregnancy.

4. A client in a coronary care unit is being admitted after CPR post cardiac arrest. The client is receiving IV lidocaine at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?

• A. Prevents dysrhythmias
• B. Slows intestinal motility
• C. Dissolves blood clots
• D. Relieves pain

Correct answer: A

Rationale: Lidocaine is administered to prevent dysrhythmias by delaying conduction in the heart and reducing the automaticity of heart tissue. This action helps stabilize the heart's electrical activity and prevent life-threatening arrhythmias post-cardiac arrest. Choices B, C, and D are incorrect as lidocaine is not used for slowing intestinal motility, dissolving blood clots, or relieving pain in this context.

5. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?

• A. Discontinue the medication if a rash develops.
• B. Expect increased salivation during the first few weeks of therapy.
• C. Avoid driving until the client's reaction to the medication is known.
• D. Stop the medication if you experience a dry mouth.

Correct answer: C

Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so engaging in activities like driving that require alertness should be avoided until the individual understands how the medication affects them. Choices A, B, and D are incorrect because they do not address the specific side effect of drowsiness associated with clonidine that could impair driving abilities. Discontinuing the medication if a rash develops, expecting increased salivation, or stopping the medication for dry mouth are not primary concerns related to clonidine therapy for hypertension.

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