Nursing Elites

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

• A. Take this medication at bedtime.
• B. Monitor for signs of hyperglycemia.
• C. Avoid drinking grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct instruction for a client prescribed Verapamil is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication. This can result in a higher risk of adverse effects, such as hypotension and bradycardia. Therefore, it is essential for the client to avoid grapefruit juice while taking Verapamil to prevent potential complications. Choices A, B, and D are incorrect because taking Verapamil at bedtime, monitoring for signs of hyperglycemia, and increasing potassium-rich foods intake are not specific instructions related to Verapamil therapy and do not address the potential interaction with grapefruit juice.

2. A healthcare professional is caring for four clients who have Peptic Ulcer Disease. The healthcare professional should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor and potentially lead to harm to the fetus. Therefore, it should not be used in pregnant clients due to its uterotonic effects. For clients with osteoarthritis, kidney stone, or urinary tract infection, Misoprostol is not contraindicated specifically for these conditions.

3. 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 a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to remove it each day, usually at bedtime, to prevent tolerance. Keeping the patch on for 24 hours at a time can lead to tolerance development. Applying the patch to a different site each day is not necessary, as long as the area is rotated to prevent skin irritation. Applying the patch over an area with little or no hair is not a critical instruction for the Nitroglycerin patch.

4. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

5. When administering digoxin (Lanoxin) to a patient, the healthcare provider observes various signs and symptoms of an overdose. Which of the following should the healthcare provider give to reverse digoxin toxicity?

• A. Naloxone
• B. Vitamin K
• C. Digibind
• D. Flumazenil

Correct answer: C

Rationale: Digibind, also known as Digoxin immune Fab, is the specific antidote used to treat digoxin toxicity. It works by binding to digoxin in the body, forming a complex that can be excreted by the kidneys, thereby reversing the toxic effects of digoxin overdose. Naloxone is used for opioid overdoses, not digoxin toxicity. Vitamin K is used to reverse the effects of warfarin overdose. Flumazenil is used to reverse the effects of benzodiazepine overdose, not digoxin toxicity.

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