Nursing Elites

1. Which statement by the client indicates a need for further teaching about the use of metoprolol (Lopressor)?

• A. I will not stop taking the medication abruptly.
• B. I will take my pulse before taking the medication.
• C. I will take the medication with food.
• D. I will take the medication at bedtime.

Correct answer: D

Rationale: The correct answer is D because taking metoprolol (Lopressor) at bedtime is not specifically recommended. Metoprolol should be taken with food to enhance absorption. It is crucial for the client not to stop taking the medication abruptly to prevent rebound hypertension or other adverse effects. Additionally, monitoring the pulse before taking metoprolol is important for assessing its effect on heart rate.

2. Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of the medication? Select one that doesn't apply.

• A. Signs of hepatitis
• B. Flu-like syndrome
• C. Low neutrophil count
• D. Vitamin B6 deficiency

Correct answer: D

Rationale: Rifabutin is known to cause side effects such as hepatitis, flu-like syndrome, low neutrophil count, and ocular pain or blurred vision. Vitamin B6 deficiency is not associated with rifabutin but is a side effect of isoniazid (INH). Therefore, the nurse should not monitor for Vitamin B6 deficiency when administering rifabutin.

3. While assisting in caring for a pregnant client receiving intravenous magnesium sulfate for preeclampsia management, a nurse notes the client's absent deep tendon reflexes. What determination should the nurse make based on this data?

• A. The magnesium sulfate is effective.
• B. The infusion rate needs to be increased.
• C. The client is experiencing cerebral edema.
• D. The client is experiencing magnesium toxicity.

Correct answer: D

Rationale: When a pregnant client receiving intravenous magnesium sulfate for preeclampsia management exhibits absent deep tendon reflexes, this indicates magnesium toxicity. Magnesium toxicity can occur as a complication of magnesium sulfate therapy, leading to suppressed reflexes. It is crucial for the nurse to recognize this sign promptly and report it to prevent further complications or harm to the client.

4. A healthcare professional is monitoring a client who is receiving intravenous amphotericin B. Which of the following should prompt the healthcare professional to notify the healthcare provider immediately?

• A. Fever
• B. Headache
• C. Nausea
• D. Oliguria

Correct answer: D

Rationale: Amphotericin B is known to cause nephrotoxicity, which can lead to kidney damage. Oliguria, which is decreased urine output, is a concerning sign of kidney dysfunction and should be reported promptly to the healthcare provider to prevent further complications. Fever, headache, and nausea are common side effects of amphotericin B but are not as critical as oliguria in indicating potential kidney damage.

5. 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.

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