Nursing Elites

1. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?

• A. Vitamin K
• B. Calcium carbonate
• C. Acetaminophen
• D. Ranitidine

Correct answer: C

Rationale: The correct answer is Acetaminophen. Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking warfarin. Warfarin works by inhibiting the clotting factors dependent on vitamin K, so Vitamin K intake should be consistent but not excessive. Calcium carbonate and ranitidine do not significantly increase the risk of bleeding when used concurrently with Warfarin.

2. A client has a new prescription for Nitroglycerin to treat angina. Which of the following instructions should the nurse include?

• A. Take this medication only when chest pain occurs.
• B. Store the medication in a cool, dry place.
• C. Apply the patch to a different site each time.
• D. Avoid consuming alcohol while taking this medication.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to apply the Nitroglycerin patch to a different site each time. This is crucial to prevent skin irritation and ensure consistent absorption of the medication. Rotating application sites is important as it helps maintain the effectiveness of the treatment and reduces the risk of skin reactions. Choice A is incorrect because Nitroglycerin is often used prophylactically to prevent angina episodes rather than just for acute chest pain. Choice B is not relevant to the administration or effectiveness of the medication. Choice D, while generally a good recommendation, is not directly related to the administration of Nitroglycerin.

3. A client has a new prescription for Levothyroxine to treat hypothyroidism. Which of the following instructions should be included in the teaching?

• A. Take this medication with food.
• B. Take this medication at bedtime.
• C. Expect to see results in 1 week.
• D. Do not discontinue the medication without consulting the provider.

Correct answer: D

Rationale: The correct instruction for a client with a new prescription for Levothyroxine to treat hypothyroidism is not to discontinue the medication without consulting the provider. Abrupt cessation could lead to the return of hypothyroid symptoms, emphasizing the importance of medical guidance when considering any changes to the treatment plan. Choice A is incorrect because Levothyroxine should be taken on an empty stomach, typically in the morning. Choice B is incorrect as it contradicts the timing of administration for Levothyroxine. Choice C is inaccurate as it usually takes a few weeks for the full effects of Levothyroxine to be seen, not just 1 week.

4. A healthcare professional reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the professional take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication, and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments. Choice B is incorrect because waiting 24 hours after taking the medication would not provide an accurate trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect because obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level, as it is the lowest concentration before the next dose.

5. A client is receiving discharge instructions for a new prescription of Prednisone. Which of the following dietary instructions should be included?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: When a client is prescribed Prednisone, there is a risk of potassium depletion due to the medication. Therefore, it is essential to increase the intake of potassium-rich foods such as bananas, oranges, and spinach to help maintain adequate potassium levels in the body and prevent complications associated with low potassium levels. Choice B and D are incorrect as there is no specific need to increase dairy products or decrease protein intake with Prednisone. Choice C is also incorrect as avoiding foods high in vitamin K is more relevant for clients taking anticoagulants like warfarin.

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