Nursing Elites

1. In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A). Sodium bicarbonate (Choice B) is not indicated for hypotension related to Verapamil use. Potassium chloride (Choice C) and Magnesium sulfate (Choice D) are not the appropriate medications to address the hypotension in this situation.

2. A client with HIV is starting therapy with zidovudine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Fatigue
• B. Blurred vision
• C. Ringing in the ears
• D. Constipation

Correct answer: A

Rationale: Fatigue is a common adverse effect of zidovudine due to its impact on bone marrow, leading to anemia. Zidovudine is known to cause bone marrow suppression, resulting in decreased production of red blood cells and subsequent fatigue.

3. A client is starting a new prescription for ferrous sulfate. Which of the following instructions should the nurse include?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Take the medication with orange juice to enhance absorption.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct answer is C: 'Take the medication with orange juice to enhance absorption.' Taking ferrous sulfate with orange juice helps enhance the absorption of iron due to the ascorbic acid present in the orange juice, which aids in iron absorption. This combination can help improve the effectiveness of the medication. Choice A, taking the medication with meals, may reduce gastrointestinal side effects but does not specifically enhance absorption. Choice B, taking the medication on an empty stomach, may lead to better absorption but can also increase the risk of gastrointestinal side effects. Choice D, taking the medication with a full glass of milk, is incorrect because calcium in milk can inhibit the absorption of iron.

4. A client has a new prescription for Efavirenz, an NNRTI. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime to prevent drowsiness.
• B. Take this medication with a glass of milk.
• C. Take this medication with a glass of juice.
• D. Take this medication at the same time every day.

Correct answer: A

Rationale: The correct instruction is to take Efavirenz at bedtime to prevent drowsiness and manage central nervous system side effects like dizziness and vivid dreams. While it is important to take the medication at the same time daily for consistent blood levels, the emphasis should be on bedtime to minimize the impact of these side effects. Choices B and C suggesting taking the medication with milk or juice are incorrect and not relevant to optimizing Efavirenz therapy.

5. A client has a new prescription for Prednisone. Which of the following instructions should be included in the discharge teaching?

• A. Increase your intake of potassium-rich foods.
• B. Avoid consuming grapefruit juice.
• C. Take this medication with food.
• D. Decrease your intake of sodium-rich foods.

Correct answer: A

Rationale: The correct answer is A: "Increase your intake of potassium-rich foods." Prednisone is associated with potassium depletion, making it important for clients to increase their intake of potassium-rich foods to prevent potential imbalances. Foods such as bananas, oranges, and spinach are good sources of potassium. Choice B, "Avoid consuming grapefruit juice," is not directly related to Prednisone use. Choice C, "Take this medication with food," is a general instruction for many medications but not specific to Prednisone. Choice D, "Decrease your intake of sodium-rich foods," is not directly related to Prednisone's side effects.

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