Nursing Elites

1. A client has been prescribed Prednisone for asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication with food to prevent nausea.
• B. Take this medication at bedtime to reduce drowsiness.
• C. Take this medication in the morning to reduce insomnia.
• D. Avoid sudden changes in position.

Correct answer: C

Rationale: Prednisone is best taken in the morning to reduce the risk of insomnia, a common side effect of corticosteroids. Instructing the client to take the medication in the morning aligns with the goal of minimizing the impact of insomnia, which can disrupt sleep patterns and affect overall well-being. Choices A, B, and D are incorrect. Taking Prednisone with food does not primarily focus on preventing nausea; taking it at bedtime does not primarily reduce drowsiness, and avoiding sudden changes in position is not a specific instruction related to Prednisone use for asthma.

2. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

• A. Document that the client experienced an anaphylactic reaction to the medication.
• B. Change the IV infusion site.
• C. Decrease the infusion rate on the IV.
• D. Apply cold compresses to the neck area.

Correct answer: C

Rationale: Flushing and tachycardia are signs of Red Man Syndrome, which can be mitigated by decreasing the infusion rate.

3. A client has a new prescription for Oxycodone/Acetaminophen. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking additional Acetaminophen while on Oxycodone/Acetaminophen. This is important to prevent exceeding the maximum recommended dose and reducing the risk of liver toxicity. Oxycodone/Acetaminophen already contains Acetaminophen, so additional intake can lead to an overdose of this component. Choices A, C, and D are incorrect. Taking the medication on an empty stomach or increasing fiber intake are not specific instructions related to this medication. Avoiding taking the medication before bedtime is not directly relevant to the combination of Oxycodone/Acetaminophen.

4. When teaching a client who has a new prescription for Dextromethorphan to suppress a cough, which adverse effect should the nurse instruct the client to monitor for?

• A. Diarrhea
• B. Anxiety
• C. Sedation
• D. Palpitations

Correct answer: C

Rationale: The correct answer is C: Sedation. Dextromethorphan can cause sedation, so the client should be advised to avoid activities that require alertness. Diarrhea, anxiety, and palpitations are not commonly associated adverse effects of Dextromethorphan.

5. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

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