Nursing Elites

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

• A. Take this medication on an empty stomach.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: Levothyroxine should be taken on an empty stomach to increase absorption and efficacy. Taking it with food or antacids can interfere with its absorption, leading to reduced effectiveness of the medication.

2. When caring for a client with a wound infection, which action should the nurse perform first in the plan of care?

• A. Administer antibiotic medication.
• B. Obtain a wound specimen for culture.
• C. Review WBC laboratory findings.
• D. Apply a dressing to the wound.

Correct answer: B

Rationale: The priority action when caring for a client with a wound infection is to obtain a wound specimen for culture before initiating antibiotic therapy. This step is crucial to identify the specific microorganism causing the infection, allowing for targeted antibiotic treatment. Reviewing WBC laboratory findings and applying a wound dressing are important steps, but obtaining a wound specimen for culture takes precedence as it guides appropriate antibiotic therapy by identifying the causative organism.

3. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

4. 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.

5. A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.

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