Nursing Elites

1. A client has a new prescription for Oxycodone/Acetaminophen, and the nurse is providing discharge instructions. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct instruction for a client with a prescription for Oxycodone/Acetaminophen is to avoid taking additional Acetaminophen while on this medication. Combining medications containing Acetaminophen can lead to exceeding the maximum recommended dose and increase the risk of liver toxicity. Therefore, it is crucial for the nurse to emphasize the importance of not taking extra Acetaminophen while on this prescription to ensure the client's safety and well-being. Choices A, C, and D are incorrect. Taking Oxycodone/Acetaminophen on an empty stomach is not necessary; increasing fiber intake is not directly related to this medication, and avoiding taking the medication before bedtime is not a specific concern associated with this prescription.

2. While caring for a client receiving epoetin alfa to treat anemia, which finding should the nurse monitor for?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Leukocytosis (increased white blood cells) and hyperkalemia (high potassium levels) are not typically associated with epoetin alfa therapy. Fever is also not a common adverse effect of this medication.

3. A client with cancer and a prescription for methotrexate PO reports bleeding gums while being assessed by a nurse in a provider's clinic. Which of the following actions should the nurse take?

• A. Explain to the client that this is an expected adverse effect.
• B. Check the value of the client's current platelet count.
• C. Instruct the client to use an electric toothbrush.
• D. Have the client make an appointment to see the dentist.

Correct answer: B

Rationale: The correct action for the nurse to take when a client on methotrexate reports bleeding gums is to check the client's current platelet count. Bleeding gums may indicate thrombocytopenia, a decreased platelet count which can be a severe side effect of methotrexate therapy. Monitoring the platelet count is crucial for early detection and management of this potentially life-threatening complication. Choice A is incorrect as bleeding gums in this context may not be an expected adverse effect of methotrexate. Choice C is irrelevant and does not address the potential underlying issue of thrombocytopenia. Choice D is not the primary action needed at this point; checking the platelet count is more urgent to assess the severity of the situation.

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

• 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 answer is B: 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Atorvastatin by inhibiting its metabolism in the body, leading to a higher risk of adverse effects, such as muscle pain and liver damage. Therefore, it is important for the client to avoid consuming grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect because Atorvastatin can be taken with or without food, at any time of the day, and there is no specific need to increase potassium-rich foods while on this medication.

5. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. It is essential to alternate nostrils daily when inhaling the medication to ensure equal distribution and optimal absorption. This technique helps prevent irritation and congestion in one nostril and enhances the effectiveness of the medication. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed, applied topically, or taken as a liquid medication after meals. Therefore, instructing the client to alternate nostrils during inhalation is the most appropriate teaching for this medication.

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