Nursing Elites

1. A client has been prescribed Warfarin for atrial fibrillation. Which of the following instructions should the nurse include in the discharge teaching?

• A. Avoid foods high in vitamin K.
• B. Take this medication with food to prevent nausea.
• C. Monitor your heart rate daily before taking the medication.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct instruction for the nurse to include in the discharge teaching for a client prescribed Warfarin is to 'Avoid foods high in vitamin K.' Foods high in vitamin K can decrease the effectiveness of Warfarin by interfering with its anticoagulant effects, potentially leading to blood clotting issues. It is crucial for clients on Warfarin therapy to maintain a consistent intake of vitamin K-containing foods to ensure the stability of the medication's effects. Choices B, C, and D are incorrect because taking Warfarin with food, monitoring heart rate daily, or limiting fluid intake are not directly related to optimizing the effectiveness of Warfarin therapy.

2. A client has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

• A. Colchicine
• B. Hydroxychloroquine
• C. Auranofin
• D. Duloxetine

Correct answer: D

Rationale: The correct answer is D, Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor commonly used to manage fibromyalgia. It helps in reducing pain and improving mood in individuals with this condition. Colchicine (Choice A) is primarily used to treat gout, while Hydroxychloroquine (Choice B) and Auranofin (Choice C) are medications used to manage conditions like rheumatoid arthritis and lupus, not fibromyalgia.

3. A healthcare provider is caring for a client who has a new prescription for Epoetin Alfa. Which of the following laboratory values should the healthcare provider monitor?

• A. WBC count.
• B. Platelet count.
• C. Hemoglobin.
• D. Serum potassium.

Correct answer: C

Rationale: Epoetin alfa is a medication that stimulates red blood cell production, so hemoglobin levels should be monitored to assess the effectiveness of the drug. Monitoring hemoglobin levels helps evaluate the response to Epoetin Alfa treatment and ensures that the client's anemia is being appropriately managed.

4. A client has a new prescription for Alteplase. Which of the following actions should the nurse plan to take?

• A. Administer the medication within 4 hours of the onset of symptoms.
• B. Reconstitute the medication with sterile saline.
• C. Administer heparin concurrently with the Alteplase infusion.
• D. Monitor for changes in level of consciousness.

Correct answer: D

Rationale: Alteplase is a thrombolytic agent used to dissolve blood clots. Patients receiving Alteplase are at risk for bleeding complications, including intracranial bleeding. Monitoring for changes in the level of consciousness is crucial as it can indicate early signs of bleeding, such as increased intracranial pressure. This rapid assessment allows for timely intervention and prevention of further complications. Choices A, B, and C are incorrect. Administering Alteplase within 4 hours of symptom onset is related to the time-sensitive nature of thrombolytic therapy for conditions like acute myocardial infarction or ischemic stroke. Reconstituting Alteplase with sterile saline is a correct step in preparing the medication for administration. Administering heparin concurrently with Alteplase is generally avoided due to the increased risk of bleeding.

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

• A. Take the medication on an empty stomach.
• B. Increase your intake of high-sodium foods.
• C. Take the medication with a full glass of milk.
• D. Expect your stools to be black and tarry.

Correct answer: A

Rationale: The correct instruction that the nurse should include for a client prescribed Sucralfate is to take the medication on an empty stomach. Sucralfate works by forming a protective barrier over ulcers, which is most effective when the stomach is empty. Taking it with food or other medications may decrease its effectiveness. Instructing the client to take Sucralfate on an empty stomach helps ensure optimal therapeutic benefits. Choices B, C, and D are incorrect because increasing high-sodium foods is not related to Sucralfate therapy, taking the medication with a full glass of milk is not recommended as it may decrease its effectiveness, and the presence of black and tarry stools is not an expected outcome of Sucralfate.

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