Nursing Elites

1. A client is being taught about the use of nitroglycerin (Nitrostat) for angina. Which statement by the client indicates a need for further teaching?

• A. I will sit or lie down when I take the medication.
• B. I can take up to three tablets, 5 minutes apart, if needed.
• C. I will call 911 if my chest pain is not relieved after taking three tablets.
• D. I will keep the medication in its original dark container.

Correct answer: B

Rationale: The correct administration of nitroglycerin for angina is to take up to three tablets, 5 minutes apart. If the chest pain persists after the third tablet, emergency medical services should be called. Taking more than three tablets or reducing the time interval between doses may lead to hypotension and indicates a need for further teaching.

2. The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?

• A. Constipation
• B. Abdominal pain
• C. An episode of diarrhea
• D. Hematest-positive nasogastric tube drainage

Correct answer: C

Rationale: Loperamide hydrochloride (Imodium) is an antidiarrheal medication commonly used to manage episodes of diarrhea. It works by slowing down gut movement and reducing the frequency of bowel movements. Loperamide is not indicated for constipation, abdominal pain, or hematest-positive nasogastric tube drainage. It is specifically useful in acute and chronic diarrhea, such as in cases of inflammatory bowel disease, to help control symptoms and decrease fluid loss.

3. The healthcare provider is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the healthcare provider specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

• A. Anemia
• B. Decreased platelets
• C. Increased uric acid level
• D. Decreased leukocyte count

Correct answer: C

Rationale: Following chemotherapy for leukemias and lymphomas, hyperuricemia is common due to the massive cell kill. Chemotherapy leads to the rapid destruction of cancer cells, releasing large amounts of nucleic acids, which are broken down into uric acid. Monitoring and managing uric acid levels are crucial to prevent complications such as renal damage and gout.

4. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:

• A. Should always be taken with food or antacids
• B. Should be double-dosed if one dose is forgotten
• C. Causes orange discoloration of sweat, tears, urine, and feces
• D. May not be discontinued independently if symptoms are gone in 3 months

Correct answer: C

Rationale: Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.

5. A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select one that doesn't apply.

• A. Nizatidine (Axid)
• B. Ranitidine (Zantac)
• C. Famotidine (Pepcid)
• D. Ibuprofen (Motrin)

Correct answer: D

Rationale: H2-receptor antagonists like Nizatidine, Ranitidine, and Famotidine are used to suppress gastric acid secretion, relieve heartburn symptoms, and prevent complications of peptic ulcer disease. Ibuprofen, on the other hand, is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and inflammation, but it is not an H2-receptor antagonist. It is essential to differentiate between these medication classes to ensure appropriate treatment for gastrointestinal conditions.

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