Nursing Elites

1. 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.

2. A client has a new prescription for Bisacodyl. Which of the following statements should the nurse include?

• A. Take the medication before bedtime.
• B. Expect a rapid heart rate.
• C. Increase your intake of high-sodium foods.
• D. Expect rectal burning with the suppository form.

Correct answer: D

Rationale: The correct statement to include when educating a client about Bisacodyl is to expect rectal burning with the suppository form. Bisacodyl, a stimulant laxative, is known to cause rectal burning when administered as a suppository. This side effect is common and expected, and it is important for the client to be aware of it to prevent unnecessary alarm or concern. Choices A, B, and C are incorrect. Taking Bisacodyl before bedtime is not a common instruction; expecting a rapid heart rate is not a typical side effect of Bisacodyl; and increasing intake of high-sodium foods is not related to the use of Bisacodyl.

3. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct instruction for the nurse to include when teaching a client with OCD who has a new prescription for Paroxetine is that it can take several weeks before the client feels like the medication is helping. Paroxetine, like other selective serotonin reuptake inhibitors (SSRIs), can take 1 to 4 weeks before the client reaches the full therapeutic benefit. Therefore, it is important to inform the client about this delay in onset of action to manage their expectations and promote adherence to the treatment plan. Choices B, C, and D are incorrect because taking Paroxetine before bedtime is not necessary, it should be taken consistently at the same time each day; Paroxetine is usually taken regularly, not as needed; and while monitoring weight is important, it is not a specific instruction related to the onset of action for Paroxetine.

4. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

5. A hospitalized client has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should be prepared for transfusion?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the appropriate blood product for a client with an elevated aPTT as it contains various coagulation factors that can help correct coagulopathies and prevent bleeding. Elevated aPTT indicates a deficiency in specific clotting factors, and fresh frozen plasma is rich in these factors. Whole blood, platelets, and packed red blood cells do not contain the necessary coagulation factors to correct an elevated aPTT, so they are not indicated in this situation.

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