Nursing Elites

1. A client has a new prescription for Folic Acid. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Expect a metallic taste in your mouth.
• C. Increase your intake of green, leafy vegetables.
• D. Avoid citrus fruits.

Correct answer: C

Rationale: The correct answer is C: 'Increase your intake of green, leafy vegetables.' Folic acid is naturally found in green, leafy vegetables. By increasing the intake of these vegetables, the client can supplement their folic acid levels. This dietary adjustment supports the client in meeting the prescription requirements and enhances the overall health benefits of folic acid. Choices A, B, and D are incorrect because they do not directly relate to increasing folic acid intake as required by the prescription.

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 healthcare professional is admitting a toddler to the hospital after an Acetaminophen overdose. Which of the following medications should the healthcare professional anticipate administering to this client?

• A. Acetylcysteine
• B. Pegfilgrastim
• C. Misoprostol
• D. Naltrexone

Correct answer: A

Rationale: The correct answer is Acetylcysteine. Acetylcysteine is the antidote for acetaminophen overdose. It works by replenishing glutathione, which is depleted in cases of acetaminophen overdose, thus preventing liver damage. Pegfilgrastim is a medication used to stimulate white blood cell production, misoprostol is a medication used to prevent gastric ulcers, and naltrexone is used in the management of opioid addiction and alcohol dependence, which are not indicated in the scenario described.

4. An older adult client has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias. The other choices, Phenytoin, Warfarin, and Aluminum hydroxide, do not significantly interact with Digoxin to cause toxicity. Phenytoin may reduce Digoxin levels, while Warfarin and Aluminum hydroxide have minimal interactions with Digoxin.

5. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Administer Propranolol to decrease the client's blood pressure.
• C. Assist the client with sitting up or standing after taking this medication.
• D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.

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