Nursing Elites

1. A nurse is caring for a client who is taking warfarin. The nurse notes that the client has a new prescription for amoxicillin. Which of the following laboratory tests should the nurse monitor closely?

• A. Serum potassium
• B. Prothrombin time (PT)
• C. Serum sodium
• D. Blood glucose

Correct answer: B

Rationale: The correct answer is B: Prothrombin time (PT). Amoxicillin can potentiate the effects of warfarin, increasing the risk of bleeding. Monitoring the prothrombin time (PT) is crucial in this situation to assess the client's clotting ability. Choices A, C, and D are incorrect because amoxicillin's interaction with warfarin does not directly impact serum potassium, serum sodium, or blood glucose levels.

2. A client who has been prescribed oral contraception receives education from a nurse. Which of the following client statements indicates a need for further education?

• A. If I miss one pill, I'll take it as soon as possible
• B. If I miss two pills, I'll double up for two days
• C. If I miss three pills, I'll double up each day until back on schedule
• D. I'll use an alternative form of contraception if I miss more than two pills

Correct answer: C

Rationale: The correct course of action after missing oral contraceptive pills depends on how many pills are missed. If three pills are missed, the client should not 'double up' but rather follow the manufacturer's instructions and use an alternative form of contraception until the next cycle. Taking too many pills at once increases the risk of side effects without restoring contraceptive protection. Choices A, B, and D demonstrate understanding of the correct actions to take after missing a pill or two, emphasizing the importance of not doubling up but following specific guidelines to maintain effectiveness and safety.

3. A nurse is caring for a postmenopausal client prescribed the aromatase inhibitor anastrozole for the treatment of breast cancer. Which of the following should the nurse inform the client she may experience?

• A. Weight gain
• B. Muscle and joint pain
• C. Night sweats
• D. Increased appetite

Correct answer: B

Rationale: The correct answer is B: Muscle and joint pain. Muscle and joint pain are common side effects of aromatase inhibitors like anastrozole. These side effects can be managed with analgesics as prescribed by the healthcare provider. Weight gain (choice A) is not typically associated with anastrozole. Night sweats (choice C) are also not commonly reported with this medication. Increased appetite (choice D) is not a common side effect of anastrozole.

4. A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which instruction should the nurse include in the teaching?

• A. Inhale the medication deeply for 3-5 seconds
• B. Exhale forcefully before inhaling
• C. Shake the MDI vigorously before use
• D. Hold the mouthpiece 2.5-5 cm (1-2 in) in front of the mouth

Correct answer: A

Rationale: Corrected Rationale: Inhaling the medication deeply for 3-5 seconds and holding the breath for 10 seconds after inhalation ensures effective medication delivery to the lungs. Choice A is the correct instruction for the use of a metered-dose inhaler (MDI). Choice B, exhaling forcefully before inhaling, is incorrect as it can lead to decreased medication delivery. Choice C, shaking the MDI vigorously before use, is also incorrect as excessive shaking can cause the medication to clump. Choice D, holding the mouthpiece 2.5-5 cm (1-2 in) in front of the mouth, is not recommended as it may lead to improper inhalation technique.

5. A client with osteoporosis is being taught by a nurse about dietary changes. Which of the following food choices should the nurse recommend to promote bone health?

• A. Leafy green vegetables
• B. Red meat
• C. Fortified orange juice
• D. Whole grains

Correct answer: C

Rationale: The correct answer is C: Fortified orange juice. Fortified orange juice is often supplemented with calcium and vitamin D, both of which are essential for bone health and the prevention of osteoporosis. Leafy green vegetables (choice A) are good for overall health but may not provide sufficient calcium for bone health. Red meat (choice B) is a source of protein but is not a primary source of calcium. Whole grains (choice D) are beneficial for fiber intake but do not contain significant amounts of calcium or vitamin D necessary for bone health.

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