Nursing Elites

1. A client is prescribed an IM dose of penicillin. The client reports developing a rash after taking penicillin 3 years ago. What should the nurse do?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The nurse should withhold the medication and inform the provider of the client's previous rash after taking penicillin. This history suggests a potential allergic reaction to penicillin, which can range from mild to severe anaphylaxis. Notifying the provider allows for an alternative antibiotic to be prescribed, considering the client's allergy to penicillin. It is crucial to avoid administering a medication that could potentially lead to a severe allergic reaction in the client. Administering the prescribed dose (Choice A) could be harmful due to the potential for an allergic reaction. Changing the prescription to an oral form (Choice C) does not address the underlying issue of a potential penicillin allergy. Administering an oral antihistamine (Choice D) without consulting the provider may not be sufficient to prevent a severe allergic reaction.

2. A client has a new prescription for Prednisone. Which of the following laboratory values should the nurse monitor?

• A. Serum potassium
• B. Serum calcium
• C. Serum sodium
• D. Serum glucose

Correct answer: D

Rationale: The correct answer is D, Serum glucose. Prednisone is a corticosteroid that can lead to hyperglycemia. Monitoring serum glucose levels is essential to assess for elevated blood sugar levels. Choices A, B, and C are incorrect as Prednisone does not directly affect potassium, calcium, or sodium levels.

3. A client with a urinary tract infection (UTI) is prescribed ciprofloxacin. Which instruction should the nurse provide to the client?

• A. If the medication causes an upset stomach, take an antacid at the same time.
• B. Increase your daily fluid intake while taking this medication.
• C. This medication can cause photophobia, so avoid direct sunlight exposure.
• D. You should report any tendon discomfort you experience while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Tendon discomfort is a potential side effect of ciprofloxacin that can lead to tendon rupture and should be reported immediately to prevent serious complications. Monitoring for this adverse effect is crucial for patient safety. Choices A, B, and C are incorrect because: A) Taking an antacid with ciprofloxacin can interfere with its absorption. B) Increasing fluid intake is generally a good recommendation but not specifically related to the side effects of ciprofloxacin. C) Photophobia is not a common side effect of ciprofloxacin; therefore, avoiding direct sunlight exposure is not necessary.

4. A client is receiving Gentamicin. Which of the following laboratory values should the nurse monitor to assess for nephrotoxicity?

• A. Serum sodium.
• B. Serum creatinine.
• C. Serum potassium.
• D. Serum glucose.

Correct answer: B

Rationale: When a client is receiving Gentamicin, the nurse should monitor serum creatinine levels to assess for nephrotoxicity. Gentamicin is known to potentially cause nephrotoxicity, leading to impaired kidney function. Monitoring serum creatinine levels helps in early detection of any kidney damage or dysfunction. Serum sodium, serum potassium, and serum glucose levels are not directly related to nephrotoxicity caused by Gentamicin, so they are not the appropriate values to monitor in this case.

5. When teaching a client with a new prescription for Simvastatin, which instruction should be included?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for Simvastatin is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Simvastatin, leading to increased blood levels of the drug and a higher risk of adverse effects such as muscle pain and liver damage. It is important to educate the client about this potential interaction to ensure the safe and effective use of the medication. Choices A, C, and D are incorrect because taking Simvastatin with food or in the morning and increasing potassium-rich foods intake are not specifically related to the safe use of Simvastatin. Avoiding grapefruit juice is crucial to prevent drug interactions.

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