Nursing Elites

1. A client is receiving discharge instructions for a new prescription of Warfarin. Which of the following over-the-counter medications should the client be instructed to avoid?

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

Correct answer: B

Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. Patients on Warfarin should avoid NSAIDs like Ibuprofen and opt for alternative pain relief options to prevent potential complications such as an increased risk of bleeding. Acetaminophen (Choice A), Diphenhydramine (Choice C), and Loratadine (Choice D) are not known to significantly interact with Warfarin in terms of bleeding risk and are generally considered safe to use alongside Warfarin.

2. A client is taking Sucralfate PO for Peptic Ulcer Disease and has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

• A. Take an antacid with the sucralfate.
• B. Take sucralfate with a glass of milk.
• C. Allow a 2-hour interval between these medications.
• D. Chew the sucralfate thoroughly before swallowing.

Correct answer: C

Rationale: Sucralfate can interfere with the absorption of phenytoin. To prevent this interaction, the client should allow a 2-hour interval between taking sucralfate and phenytoin. This timing helps to ensure adequate absorption and effectiveness of both medications without compromising therapeutic outcomes. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, and chewing sucralfate thoroughly before swallowing do not address the need for a 2-hour interval between these medications to prevent interference with phenytoin absorption.

3. A client has a new prescription for Amlodipine. Which of the following side effects should the client monitor for and report?

• A. Swelling of the ankles.
• B. Increased urination.
• C. Persistent cough.
• D. Dark-colored urine.

Correct answer: A

Rationale: Corrected Rationale: Amlodipine, a calcium channel blocker, can cause peripheral edema (swelling of the ankles) as a side effect. This occurs due to the dilation of blood vessels and increased fluid retention. It is important for the client to monitor for ankle swelling as it could indicate a potential adverse reaction to the medication. Reporting this side effect to the healthcare provider is crucial to ensure appropriate management and potential adjustment of the treatment plan.\n Choice B, increased urination, is not a common side effect of Amlodipine. Choice C, persistent cough, is more commonly associated with ACE inhibitors rather than calcium channel blockers like Amlodipine. Choice D, dark-colored urine, is not a typical side effect of Amlodipine and is not something the client should specifically monitor for and report while taking this medication.

4. When using Nitroglycerine (transdermal), how many hours should you be nitrate-free each day?

• A. 1-2 hours
• B. 5-10 hours
• C. 3-4 hours
• D. 10-12 hours

Correct answer: D

Rationale: When using Nitroglycerine (transdermal), it should be applied for 10-12 hours per day to ensure its effectiveness. A nitrate-free period within the day is essential to prevent the development of tolerance to the medication.

5. A client has a new prescription for Nitroglycerin to treat angina. Which of the following instructions should be included?

• A. Take this medication only when experiencing chest pain.
• B. Store the medication in a cool, dry place.
• C. Apply the patch to a different site each time.
• D. Do not cut the patch regardless of your blood pressure.

Correct answer: C

Rationale: When using Nitroglycerin patches to treat angina, it is crucial to apply the patch to a different site each time. This practice helps prevent skin irritation and ensures proper absorption of the medication, optimizing its effectiveness in managing angina symptoms.

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