Nursing Elites

1. A client is receiving treatment with methotrexate. Which of the following supplements should the nurse instruct the client to take?

• A. Folic acid
• B. Vitamin D
• C. Calcium
• D. Iron

Correct answer: A

Rationale: The nurse should instruct the client to take folic acid when receiving treatment with methotrexate to reduce the risk of methotrexate toxicity. Methotrexate acts as a folic acid antagonist, leading to folic acid deficiency, which can be counteracted by supplementing with folic acid. Vitamin D, calcium, and iron are not specifically recommended to counteract methotrexate effects and do not play a significant role in mitigating methotrexate toxicity.

2. The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching?

• A. Decrease salt and fat intake and limit alcohol intake.
• B. There are no dietary restrictions for a person diagnosed with angina.
• C. Limit smoking and increase protein and sugar intake.
• D. Increase fruits, vegetables, and foods high in cholesterol.

Correct answer: A

Rationale: The correct answer is to decrease salt and fat intake and limit alcohol intake. These dietary changes can help manage angina by reducing the workload on the heart and preventing further plaque buildup in the arteries. Choices B, C, and D are incorrect as dietary restrictions for angina typically involve reducing salt, fat, and alcohol intake, rather than increasing sugar or cholesterol intake.

3. When discussing immunizations, which vaccine series is typically completed before a child's first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The rotavirus vaccine series is usually completed before a child's first birthday. It is given to infants in a series of doses starting at 2 months of age and must be completed by 8 months of age. This vaccine helps protect against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the Pneumococcal conjugate vaccine, Meningococcal conjugate vaccine, and Varicella vaccine are not typically completed before a child's first birthday.

4. 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 (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.

5. When a client has a new prescription for Warfarin, which of the following foods should they avoid based on the nurse's instructions?

• A. Broccoli
• B. Bananas
• C. Chicken
• D. Potatoes

Correct answer: A

Rationale: Clients prescribed Warfarin should avoid foods high in vitamin K, like broccoli, as they can counteract the medication's effectiveness. Warfarin works by inhibiting vitamin K-dependent clotting factors, so consuming high vitamin K foods can interfere with its anticoagulant effects. Bananas, chicken, and potatoes are not high in vitamin K and do not have a significant impact on Warfarin therapy.

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