Nursing Elites

1. 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.

2. Which of the following is considered a class IA Sodium Channel blocker?

• A. Mexiletine
• B. Amiodarone
• C. Quinidine
• D. Procainamide

Correct answer: D

Rationale: Procainamide is a class IA antiarrhythmic drug that acts as a sodium channel blocker by blocking fast sodium channels. Mexiletine is a class IB antiarrhythmic drug, not class IA. Amiodarone is a class III antiarrhythmic, and Quinidine is a class IA antiarrhythmic but not a sodium channel blocker.

3. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV for Preeclampsia, a urinary output less than 25 to 30 mL/hr indicates magnesium sulfate toxicity and should be reported to the provider for further evaluation and management. Choice A, 2+ deep tendon reflexes, is a normal finding with magnesium sulfate therapy. Choice B, 2+ pedal edema, is expected in clients with preeclampsia but does not indicate magnesium sulfate toxicity. Choice D, respirations 12/min, is within the normal range and not a concerning finding related to magnesium sulfate administration.

4. A client is being discharged with a new prescription for Fluoxetine for PTS. Which of the following statements should the nurse include in the teaching?

• A. You may experience a decreased desire for intimacy while taking this medication.
• B. You should take this medication in the morning to avoid sleep disturbances.
• C. To minimize urinary adverse effects, ensure you urinate before taking this medication.
• D. It is recommended to wear sunglasses outdoors due to the light sensitivity caused by this medication.

Correct answer: A

Rationale: The correct statement for the nurse to include in the teaching is that the client may experience a decreased desire for intimacy while taking Fluoxetine for PTS. This is important because Fluoxetine, an SSRI used to treat PTS, can lead to decreased libido as a potential adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with Fluoxetine and are not directly relevant to the medication's effects for this patient.

5. A client with a new prescription for Escitalopram for the treatment of generalized anxiety disorder is being taught by a healthcare provider. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication on an empty stomach.
• B. I will follow a low-sodium diet while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I should not crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. This gradual reduction helps minimize potential withdrawal symptoms and ensures a safer discontinuation process. Choices A, B, and D are incorrect because taking escitalopram on an empty stomach, following a low-sodium diet, and not crushing the medication are not directly related to the safe and effective use of the medication or its discontinuation process.

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