Nursing Elites

1. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following herbal supplements should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism pathways, potentially leading to decreased anticoagulant effects. Therefore, clients on Warfarin therapy should avoid St. John's wort. While echinacea, garlic, and ginseng are also herbal supplements that can interact with Warfarin, St. John's wort is particularly known for its significant impact on Warfarin metabolism. Echinacea may increase the risk of bleeding when taken with Warfarin, garlic may potentiate the anticoagulant effects of Warfarin, and ginseng may also increase the risk of bleeding. However, St. John's wort is the most crucial to avoid due to its significant impact on Warfarin metabolism.

2. When should Montelukast be taken?

• A. At least two hours before exercise
• B. Daily in the evening
• C. Two hours before exercise or daily in the evening
• D. None of the above

Correct answer: B

Rationale: Montelukast should be taken daily in the evening to effectively manage asthma symptoms. Taking it at the same time each day helps maintain a consistent level of the medication in the body, providing optimal control over asthma symptoms and inflammation. Choice A is incorrect because Montelukast should not be taken specifically before exercise, but rather daily. Choice C is incorrect because although taking Montelukast two hours before exercise is not necessary, taking it daily in the evening is essential for its effectiveness. Choice D is incorrect as Montelukast should be taken daily to manage asthma.

3. A client is starting therapy with docetaxel. Which of the following findings should the nurse instruct the client to report?

• A. Flushing
• B. Dyspnea
• C. Hyperglycemia
• D. Tinnitus

Correct answer: B

Rationale: The correct answer is B: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a severe adverse effect of docetaxel. Dyspnea may suggest a potential serious condition that needs prompt evaluation and intervention to prevent complications. Flushing (choice A) is more commonly associated with other medications or conditions and is not a common side effect of docetaxel. Hyperglycemia (choice C) and tinnitus (choice D) are also not typically associated with docetaxel therapy and are not priority findings that the nurse should instruct the client to report.

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

• A. Massage the injection site after administration.
• B. Aspirate before injecting the medication.
• C. Administer the medication into the abdomen.
• D. Administer the medication via intramuscular injection.

Correct answer: C

Rationale: The correct answer is to administer the medication into the abdomen. Enoxaparin is a medication that is administered subcutaneously, typically in the abdomen to ensure proper absorption. Massaging the injection site should be avoided as it can lead to bruising or bleeding under the skin. Aspirating before injecting the medication is not necessary for subcutaneous injections like Enoxaparin. Administering the medication via intramuscular injection is incorrect as Enoxaparin should be given subcutaneously.

5. A healthcare professional is preparing to administer furosemide 80 mg PO daily. The available furosemide oral solution is 10 mg/1 mL. How many mL should the healthcare professional administer?

• A. 8 mL
• B. 10 mL
• C. 6 mL
• D. 12 mL

Correct answer: A

Rationale: To determine the volume to administer, divide the desired dose by the available concentration. In this case, 80 mg divided by 10 mg/mL equals 8 mL. Therefore, the healthcare professional should administer 8 mL of furosemide oral solution. Choice B, 10 mL, is incorrect as it does not reflect the accurate calculation. Choices C and D, 6 mL and 12 mL respectively, are also incorrect as they do not match the correct calculation based on the provided concentration and dose.

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