Nursing Elites

1. When teaching a client about a new prescription for Celecoxib, which of the following information should the nurse include?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The nurse should educate the client that taking Celecoxib increases the risk of a myocardial infarction due to its suppression of vasodilation. Celecoxib belongs to the class of NSAIDs known to have cardiovascular risks, including an increased risk of heart attacks. Choice B is incorrect because Celecoxib does not decrease the risk of stroke. Choice C is incorrect because Celecoxib selectively inhibits COX-2 rather than COX-1. Choice D is incorrect because Celecoxib does not increase platelet aggregation; in fact, it inhibits platelet aggregation.

2. A client with a urinary tract infection (UTI) is prescribed ciprofloxacin. Which instruction should the nurse provide to the client?

• A. If the medication causes an upset stomach, take an antacid at the same time.
• B. Increase your daily fluid intake while taking this medication.
• C. This medication can cause photophobia, so avoid direct sunlight exposure.
• D. You should report any tendon discomfort you experience while taking this medication.

Correct answer: D

Rationale: The correct answer is D. Tendon discomfort is a potential side effect of ciprofloxacin that can lead to tendon rupture and should be reported immediately to prevent serious complications. Monitoring for this adverse effect is crucial for patient safety. Choices A, B, and C are incorrect because: A) Taking an antacid with ciprofloxacin can interfere with its absorption. B) Increasing fluid intake is generally a good recommendation but not specifically related to the side effects of ciprofloxacin. C) Photophobia is not a common side effect of ciprofloxacin; therefore, avoiding direct sunlight exposure is not necessary.

3. A client has a prescription for Amphotericin B. Which of the following laboratory values should be monitored by the nurse to assess for an adverse effect of this medication?

• A. Serum creatinine.
• B. Serum potassium.
• C. Serum sodium.
• D. Serum calcium.

Correct answer: A

Rationale: Corrected Rationale: Amphotericin B is known to cause nephrotoxicity, a potential adverse effect that can be monitored by checking the client's serum creatinine levels. Regular monitoring of serum creatinine helps in early identification of kidney damage and allows for timely intervention to prevent further complications. Choice B, serum potassium, is not typically associated with adverse effects of Amphotericin B. Choice C, serum sodium, and choice D, serum calcium, are not directly affected by Amphotericin B and are not primary indicators of its adverse effects.

4. A client has been prescribed a new oral hypoglycemic agent for diabetes. Which of the following statements by the client indicates a need for further teaching?

• A. I will take this medication with my evening snack.
• B. I will monitor my blood sugar levels before each meal.
• C. I will take this medication as soon as I wake up.
• D. I will follow my exercise plan as usual.

Correct answer: A

Rationale: Taking an oral hypoglycemic agent with an evening snack may lead to hypoglycemia during the night. It is important to follow the prescribed timing for medication administration to maintain blood sugar levels within the target range. The medication is usually taken before meals to help control postprandial blood glucose levels effectively. Choice B is correct as monitoring blood sugar levels before each meal is a good practice. Choice C is incorrect as taking the medication upon waking up may align with certain oral hypoglycemic agents' dosing schedules. Choice D is also correct as regular exercise is an important part of managing diabetes.

5. When administering subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty, what action should the nurse plan to take?

• A. Expel any air bubbles from the prefilled syringe before injecting.
• B. Insert the needle completely into the client's tissue.
• C. Administer the injection in the client's thigh.
• D. Aspirate carefully after inserting the needle into the client's skin.

Correct answer: B

Rationale: When administering enoxaparin via a prefilled syringe for deep subcutaneous injection, the nurse should insert the needle completely into the client's tissue. This action ensures proper delivery of the medication into the subcutaneous layer, promoting optimal therapeutic effects. Choice A is incorrect because there is no need to expel air bubbles from a prefilled syringe. Choice C is incorrect as enoxaparin is typically administered in the abdomen for subcutaneous injections. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or damage to tissues.

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