Nursing Elites

1. When reviewing laboratory results for a client receiving tacrolimus (Prograf), which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?

• A. Blood glucose of 200 mg/dL
• B. Potassium level of 3.8 mEq/L
• C. Platelet count of 300,000 cells/mm³
• D. White blood cell count of 6000 cells/mm³

Correct answer: A

Rationale: An elevated blood glucose level of 200 mg/dL indicates an adverse effect of tacrolimus. This finding suggests hyperglycemia, which is a known adverse effect of the medication. Other potential adverse effects of tacrolimus include neurotoxicity and hypertension. Monitoring blood glucose levels is crucial to detect and manage this adverse effect promptly. Choices B, C, and D are not directly associated with adverse effects of tacrolimus. Potassium, platelet count, and white blood cell count are important parameters to monitor for other reasons but not specifically for detecting adverse effects of tacrolimus.

2. A client is taking ticlopidine hydrochloride (Ticlid). The nurse tells the client to avoid which of the following while taking this medication?

• A. Vitamin C
• B. Vitamin D
• C. Acetaminophen (Tylenol)
• D. Acetylsalicylic acid (aspirin)

Correct answer: D

Rationale: Ticlopidine hydrochloride is a platelet aggregation inhibitor. Aspirin or any aspirin-containing product should be avoided as they can precipitate or aggravate bleeding by affecting platelet function and increasing the risk of bleeding complications.

3. A healthcare provider has written a prescription for ranitidine (Zantac), once daily. When should the nurse schedule the medication?

• A. At bedtime
• B. After lunch
• C. With supper
• D. Before breakfast

Correct answer: A

Rationale: The correct answer is A: At bedtime. Ranitidine should be scheduled at bedtime because it provides a prolonged effect and offers the greatest protection of the gastric mucosa. Administering it at this time helps in managing nocturnal acid breakthrough and providing relief during the night.

4. A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?

• A. Take the medication with a full glass of water.
• B. Increase your intake of purine-rich foods.
• C. Stop taking the medication if you experience a gout attack.
• D. Take the medication with or without food.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.

5. A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is experiencing a therapeutic effect from this medication?

• A. Abdominal pain
• B. Reduction in steatorrhea
• C. Hematest-negative stools
• D. Regular bowel movements

Correct answer: D

Rationale: The therapeutic effect of docusate sodium (Colace) is to soften stools and promote regular bowel movements, making option D the correct choice. Monitoring for regular bowel movements would indicate that the medication is working as intended by relieving or preventing constipation. Options A, B, and C are not directly related to the therapeutic effect of docusate sodium. Abdominal pain (option A) is a symptom that might indicate a problem rather than a therapeutic effect. Reduction in steatorrhea (option B) and Hematest-negative stools (option C) are not specific outcomes associated with docusate sodium.

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