Nursing Elites

1. A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Rise slowly from a sitting position.
• C. Avoid salt substitutes.
• D. Avoid exposure to sunlight.

Correct answer: C

Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.

2. A client with brain cancer and headaches is prescribed dexamethasone. What is the purpose of this adjuvant medication?

• A. To decrease inflammation and swelling
• B. To improve concentration
• C. To induce sedation
• D. To treat depression

Correct answer: A

Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer to decrease inflammation and swelling. It helps reduce cerebral edema and relieve pressure caused by the tumor, ultimately alleviating headaches. The purpose of prescribing dexamethasone in this case is not to improve concentration (choice B), induce sedation (choice C), or treat depression (choice D). Methylphenidate, a stimulant, is used for conditions like ADHD, not for brain cancer. Hydroxyzine, an antihistamine, is primarily used for anxiety and itching, not for brain cancer. Amitriptyline, a tricyclic antidepressant, is used for conditions like depression and neuropathic pain, not specifically for brain cancer-related headaches.

3. When administering IV Acyclovir to a client with Varicella, what action should the nurse take?

• A. Administer a stool softener
• B. Decrease fluid intake following infusion
• C. Infuse Acyclovir over 1 hr
• D. Monitor for hypotension

Correct answer: C

Rationale: When administering IV Acyclovir to a client with Varicella, the nurse should infuse the medication over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects such as renal damage. Therefore, it is crucial to follow the recommended infusion rate to ensure the client's safety and well-being. Choice A is incorrect as stool softeners are not indicated in this situation. Choice B is incorrect because fluid intake should be maintained or increased to prevent dehydration and support kidney function. Choice D is incorrect as monitoring for hypotension is not specifically related to the administration of IV Acyclovir in Varicella.

4. A client has a new prescription for Pancrelipase for chronic pancreatitis. Which of the following instructions should be included by the nurse?

• A. Take the medication with meals and snacks.
• B. Chew the tablet thoroughly before swallowing.
• C. Take the medication 1 hour before meals.
• D. Expect the stool to be yellow.

Correct answer: A

Rationale: The correct instruction for taking Pancrelipase is to take it with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This helps optimize the effectiveness of the medication in managing chronic pancreatitis. Choice B is incorrect because Pancrelipase should not be chewed but swallowed whole. Choice C is incorrect as the medication should be taken with meals. Choice D is incorrect because while Pancrelipase can cause stool changes, yellow stool is not an expected outcome.

5. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause a non-productive cough due to its effect on bradykinin levels. The client should be advised to report this symptom to their healthcare provider to consider alternative treatments. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not typically associated with Enalapril use.

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