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. A client has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

• A. Take the medication with food.
• B. Plan to take the medication at bedtime.
• C. Expect increased swelling of the ankles.
• D. Fluid intake should be limited in the morning.

Correct answer: A

Rationale: The correct answer is to take the medication with food. Hydrochlorothiazide should be taken with or after meals to prevent gastrointestinal upset. Taking it with food can help reduce the chances of stomach discomfort or nausea. It is not necessary to take the medication at bedtime, expect increased swelling of the ankles, or limit fluid intake in the morning when taking Hydrochlorothiazide. Therefore, choices B, C, and D are incorrect.

3. A client is prescribed Digoxin. Which of the following findings should the nurse monitor as a sign of potential toxicity?

• A. Bradycardia
• B. Hypertension
• C. Hyperglycemia
• D. Hypocalcemia

Correct answer: A

Rationale: Corrected Rationale: Bradycardia is a common sign of Digoxin toxicity. Digoxin, a medication used to treat heart conditions, can lead to toxicity manifesting as bradycardia. Monitoring the client's heart rate closely is crucial to detect potential toxicity early and prevent complications. Hypertension, hyperglycemia, and hypocalcemia are not typically associated with Digoxin toxicity. Therefore, options B, C, and D are incorrect.

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

• A. Drink 2 liters of water daily.
• B. Avoid taking the medication on an empty stomach.
• C. Limit vitamin C intake while taking this medication.
• D. Take an iron supplement while on this medication.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol is to drink 2 liters of water daily. This recommendation aims to reduce the risk of kidney stones, a potential side effect associated with allopurinol use. Adequate hydration helps prevent the formation of uric acid crystals in the kidneys, which can lead to kidney stones. Therefore, encouraging increased water intake is essential in the management of clients taking allopurinol.

5. A client is receiving Cefotaxime IV for a severe infection. Which finding indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?

• A. Diaphoresis
• B. Epistaxis
• C. Diarrhea
• D. Alopecia

Correct answer: C

Rationale: Diarrhea is an adverse effect of cefotaxime and other cephalosporins that requires reporting to the provider. Severe diarrhea might indicate the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening. Diaphoresis, epistaxis, and alopecia are not typically associated with cefotaxime use and are less likely to indicate a serious adverse reaction necessitating immediate reporting.

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