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. When educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of green, leafy vegetables.
• D. Expect your stools to turn clay-colored.

Correct answer: B

Rationale: The correct instruction for the nurse to include when educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia is to avoid drinking grapefruit juice. Grapefruit juice can increase the blood levels of atorvastatin, leading to an elevated risk of serious side effects such as liver damage and muscle problems. It is essential for the client to be aware of this potential interaction and to follow the nurse's advice to avoid grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect. Taking Atorvastatin in the morning is a common recommendation but not the priority over avoiding grapefruit juice. Increasing intake of green, leafy vegetables is generally a healthy dietary choice but is not specific to the medication. Expecting stools to turn clay-colored is not a common side effect of Atorvastatin.

3. A healthcare professional is preparing to administer Diltiazem IV to a client who has atrial fibrillation. Which of the following findings should the healthcare professional report immediately?

• A. Bradycardia.
• B. Hypertension.
• C. Shortness of breath.
• D. Tachycardia.

Correct answer: A

Rationale: The correct answer is bradycardia. Diltiazem, a calcium channel blocker, can lead to bradycardia as a side effect. Bradycardia should be reported immediately because it can result in serious cardiac complications, especially in a client with atrial fibrillation. Hypertension, shortness of breath, and tachycardia are not typically associated with Diltiazem administration and would not be immediate concerns in this scenario.

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

• A. Four medications decrease the risk of a severe allergic reaction.
• B. Four medications reduce the chance that the bacteria will become resistant.
• C. Four medications reduce the risk of adverse reactions.
• D. Four medications decrease the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: The correct answer is B. When treating tuberculosis, using a combination of medications is crucial to reduce the risk of bacteria developing resistance to any single drug. This approach helps prevent treatment failure and ensures successful treatment outcomes. Choice A is incorrect because the primary purpose of using multiple medications is not related to allergic reactions. Choice C is incorrect as the risk reduction is mainly focused on bacterial resistance rather than adverse reactions. Choice D is not relevant as the purpose of taking multiple medications is not to affect the tuberculin skin test results.

5. A healthcare professional is caring for a client who is receiving heparin therapy. Which of the following laboratory tests should the healthcare professional monitor to evaluate the therapeutic effect of heparin?

• A. PT/INR
• B. Platelet count
• C. aPTT
• D. WBC count

Correct answer: C

Rationale: The correct test to monitor the therapeutic effect of heparin is the activated partial thromboplastin time (aPTT). Heparin's action is to prolong the clotting time, and aPTT reflects this effect. Monitoring aPTT helps ensure that the client is within the therapeutic range to prevent clot formation while minimizing the risk of bleeding complications. PT/INR is used to monitor warfarin therapy, platelet count assesses for potential thrombocytopenia, and WBC count evaluates for signs of infection or inflammation, not the therapeutic effect of heparin.

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