Nursing Elites

1. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to the same site each day.
• B. Remove the patch at night.
• C. Cover the patch with a heating pad.
• D. Apply the patch to a hairless area of skin.

Correct answer: D

Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.

2. A client has a new prescription for Nevirapine, an NNRTI. Which of the following statements should the nurse include in teaching the client?

• A. Take this medication on an empty stomach.
• B. Take this medication with food to increase absorption.
• C. Avoid alcohol while taking this medication.
• D. Take this medication at the same time every day.

Correct answer: B

Rationale: The correct statement that the nurse should include in teaching the client about Nevirapine, an NNRTI, is to take the medication with food to improve gastrointestinal tolerance and prevent nausea. While absorption is not significantly affected by food, taking it with meals can help reduce adverse gastrointestinal effects. Choice A is incorrect because Nevirapine should not be taken on an empty stomach. Choice C is generally true for most medications but is not specific to Nevirapine. Choice D is a good practice for medication adherence but is not specific to the administration requirements of Nevirapine.

3. When a client is receiving treatment with methotrexate, which supplement should the nurse instruct the client to take?

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

Correct answer: A

Rationale: Folic acid supplementation is crucial for clients undergoing methotrexate treatment because methotrexate functions as a folic acid antagonist. By supplementing with folic acid, the risk of methotrexate toxicity can be minimized, improving the treatment's effectiveness and safety. Vitamin D, calcium, and iron are not specifically recommended in conjunction with methotrexate therapy and may not provide the same protective benefits as folic acid.

4. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

5. A client has a new prescription for Ondansetron. Which of the following statements should the nurse include?

• A. Take the medication 30 minutes before chemotherapy.
• B. Expect your urine to turn orange.
• C. Increase your intake of high-fiber foods.
• D. Avoid drinking grapefruit juice.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication 30 minutes before chemotherapy.' Ondansetron, an antiemetic, should be taken before chemotherapy to prevent nausea and vomiting. Taking it 30 minutes before chemotherapy ensures the medication is most effective in controlling chemotherapy-induced nausea and vomiting. Choices B, C, and D are incorrect. Option B is unrelated to Ondansetron, option C is not necessary for this medication, and option D does not interact with Ondansetron but is relevant for other medications.

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