Nursing Elites

1. When completing a nursing history for a client taking Simvastatin, which of the following disorders should the nurse identify as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in clients with active moderate-to-severe liver disorders, particularly if they are already on a statin like simvastatin. Hepatitis C is a liver condition that can be exacerbated by Ezetimibe, leading to potential complications. Therefore, the nurse should identify active hepatitis C as a contraindication to adding Ezetimibe to the client's medications. Choices A, B, and D are incorrect because they are not directly related to the contraindication of Ezetimibe in clients taking Simvastatin.

2. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following over-the-counter medications should the provider instruct the client to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs like ibuprofen and opt for alternative pain relief options such as acetaminophen. Diphenhydramine and loratadine are antihistamines and are generally safe to use with Warfarin as they do not significantly increase the risk of bleeding when compared to NSAIDs like ibuprofen.

3. A client is being educated about the use of Fluticasone to treat Perennial Rhinitis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should use the spray every 4 hours while I am awake.
• B. It can take as long as 3 weeks before the medication takes maximum effect.
• C. This medication can also be used to treat motion sickness.
• D. I can use this medication when my nasal passages are blocked.

Correct answer: B

Rationale: The correct answer is B because Fluticasone may show some benefits within a few hours, but its full therapeutic effect may take up to 3 weeks to be achieved in treating Perennial Rhinitis. Option A is incorrect as the frequency of Fluticasone use is usually once daily. Option C is incorrect as Fluticasone is not used for motion sickness. Option D is incorrect as Fluticasone is a preventive medication and not used for immediate relief when nasal passages are blocked.

4. A nurse is caring for a client who has a new prescription for Metformin. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid eating foods high in potassium.
• C. Take this medication at bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct instruction for a client prescribed Metformin is to take the medication with food. Taking Metformin with meals helps reduce gastrointestinal side effects and ensures better absorption. Choice B, to avoid foods high in potassium, is not directly related to Metformin. Choice C, taking the medication at bedtime, is not a standard instruction for Metformin. Choice D, taking the medication every other day, is incorrect as Metformin is typically taken daily as prescribed.

5. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Monitor for signs of hyperglycemia.
• C. Avoid drinking grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication, which can potentiate its effects, potentially causing adverse reactions like hypotension and bradycardia. Choices A, B, and D are incorrect. Taking Verapamil at bedtime is not a specific instruction related to its metabolism or side effects. Monitoring for signs of hyperglycemia is not directly related to Verapamil use. Increasing potassium-rich foods intake is not necessary with Verapamil and could potentially lead to hyperkalemia in some cases.

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