Nursing Elites

1. When educating a client with a new prescription for Omeprazole to manage GERD, which of the following information should the nurse include?

• A. Take the medication before meals.
• B. You may need to take this medication for a long time.
• C. Increase your intake of vitamin C while taking this medication.
• D. Expect immediate relief of symptoms.

Correct answer: A

Rationale: The correct answer is to take the medication before meals. Omeprazole should be taken before meals to ensure its effectiveness in reducing stomach acid production. This timing allows the medication to work on reducing acid secretion when the stomach is most actively producing it, leading to better control of symptoms. Choice B is incorrect because not all patients with GERD need to take Omeprazole for the rest of their lives; the duration of treatment varies. Choice C is incorrect as there is no specific recommendation to increase vitamin C intake while taking Omeprazole. Choice D is incorrect because Omeprazole may take a few days to start providing symptom relief, so immediate relief should not be expected.

2. A client is taking Epoetin Alfa for anemia. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count
• B. Platelet count
• C. Hematocrit
• D. Serum potassium level

Correct answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy since it stimulates red blood cell production. Hematocrit reflects the volume of red blood cells in the blood, providing a direct measure of the therapy's impact on increasing red blood cell mass and addressing anemia. Monitoring white blood cell count and platelet count is not directly related to assessing the effectiveness of Epoetin Alfa therapy for anemia. Serum potassium level monitoring may be necessary due to potential side effects of the medication, but it is not the primary indicator of therapy effectiveness in treating anemia.

3. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• A. This medication can safely be taken during pregnancy.
• B. Eliminate grapefruit juice from your diet.
• C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
• D. Notify your provider if you develop a rash.

Correct answer: B

Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.

4. A client has a new prescription for a combination of oral NRTIs (abacavir, lamivudine, and zidovudine) for the treatment of HIV. Which of the following statements should the nurse include in teaching the client?

• A. These medications work by blocking HIV entry into cells.
• B. These medications work by weakening the cell wall of the HIV virus.
• C. These medications work by inhibiting enzymes to prevent HIV replication.
• D. These medications work by preventing protein synthesis within the HIV cell.

Correct answer: C

Rationale: The NRTI antiretroviral medications this client is prescribed work by inhibiting the enzyme reverse transcriptase, thus preventing HIV replication. By inhibiting this crucial enzyme, the drug interferes with the virus's ability to replicate and spread in the body. Choice A is incorrect because NRTIs do not block HIV entry into cells. Choice B is incorrect as NRTIs do not weaken the cell wall of the virus. Choice D is incorrect as NRTIs do not prevent protein synthesis within the HIV cell.

5. Which of the following is the antidote for lead poisoning?

• A. Naloxone
• B. Nitrite
• C. CaEDTA
• D. Dialysis

Correct answer: C

Rationale: Calcium disodium ethylenediaminetetraacetic acid (CaEDTA) is the antidote for lead poisoning. CaEDTA works by chelating lead, forming a complex that is then excreted in the urine. It is used in chelation therapy to treat lead poisoning by reducing lead levels in the body.

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