Nursing Elites

1. A client with active pulmonary tuberculosis (TB) is to be started on intravenous rifampin therapy. The client should be informed by the nurse that this medication can cause which of the following adverse effects?

• A. Constipation
• B. Black-colored stools
• C. Staining of teeth
• D. Body secretions turning a red-orange color

Correct answer: D

Rationale: The correct answer is D: Body secretions turning a red-orange color. Rifampin is known to cause body secretions, such as urine, sweat, tears, and sputum, to turn a harmless red-orange color. This is a common and expected side effect of rifampin therapy. Choices A, B, and C are incorrect. Constipation is not a common adverse effect of rifampin. Black-colored stools and staining of teeth are not associated with rifampin therapy. It is important for the nurse to educate the client about the harmless red-orange discoloration that may occur with this medication.

2. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

3. A client is taking Warfarin for atrial fibrillation. Which of the following client statements indicates a need for further teaching?

• A. I will avoid eating broccoli.
• B. I will use an electric razor to shave.
• C. I will take aspirin for headaches.
• D. I will have my blood tested regularly.

Correct answer: C

Rationale: The correct answer is C. Taking aspirin along with Warfarin can increase the risk of bleeding. Clients should be advised to avoid medications that increase the risk of bleeding when taking Warfarin to prevent complications. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding foods high in Vitamin K, using an electric razor to prevent cuts that can lead to bleeding, and regular blood testing to monitor Warfarin levels are all important aspects of managing Warfarin therapy.

4. When starting therapy with Lisinopril, a client should be instructed to monitor for which of the following adverse effects?

• A. Tinnitus
• B. Diarrhea
• C. Cough
• D. Weight gain

Correct answer: C

Rationale: The correct answer is C: Cough. Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. Clients should be informed to monitor for this side effect and report it to their healthcare provider if it occurs. Choices A, B, and D are incorrect because tinnitus, diarrhea, and weight gain are not commonly associated with Lisinopril therapy.

5. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?

• A. Vitamin K1
• B. Protamine
• C. Omeprazole
• D. Probenecid

Correct answer: C

Rationale: Omeprazole, a proton pump inhibitor, is prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help manage these symptoms effectively. Choice A, Vitamin K1, is incorrect as it antagonizes the activity of Dabigatran, counteracting its anticoagulant effect. Choice B, Protamine, is used to reverse the anticoagulant effects of heparin, not dabigatran. Choice D, Probenecid, is not typically used to treat adverse effects of dabigatran.

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