Nursing Elites

1. A client has a new prescription for Captopril. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: The correct answer is to instruct the client to notify the provider if they develop a persistent cough. A persistent cough is a common adverse effect of Captopril and other ACE inhibitors. It is essential for the client to inform their healthcare provider promptly if this side effect occurs, as it may indicate a potentially serious issue that needs medical attention.

2. A client has a new prescription for Losartan. Which of the following laboratory values should the nurse monitor?

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

Correct answer: A

Rationale: Corrected Rationale: Losartan, an angiotensin II receptor blocker (ARB), can cause hyperkalemia. The nurse should monitor the client's serum potassium levels closely because Losartan can increase potassium levels, potentially leading to serious complications such as arrhythmias. Monitoring serum sodium, calcium, or magnesium levels is not typically necessary when a patient is prescribed Losartan, as these values are not directly affected by this medication.

3. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital has a long half-life of 4 days, meaning it remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should expect to administer phenobarbital once a day to maintain therapeutic levels and effectiveness. Administering it more than once a day would lead to unnecessary dosing and potential adverse effects as the medication remains active in the body for an extended period.

4. A healthcare provider is providing discharge instructions to a client who is prescribed Warfarin. Which of the following dietary instructions should the provider include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is to avoid foods high in vitamin K. Vitamin K can interfere with the effectiveness of Warfarin by counteracting its anticoagulant effects. Foods high in vitamin K, such as leafy green vegetables, should be limited in the diet of individuals taking Warfarin to maintain a consistent level of the medication's effectiveness. Choices A, C, and D are incorrect as increasing intake of leafy green vegetables (choice A) and dairy products (choice C) may increase the intake of vitamin K, which is not recommended, and avoiding foods high in iron (choice D) is not directly related to Warfarin therapy.

5. A healthcare professional is obtaining a medication history from a client who is to receive Imipenem-cilastatin IV to treat an infection. Which of the following medications the client also receives puts them at risk for a medication interaction?

• A. Regular insulin
• B. Furosemide
• C. Valproic acid
• D. Ferrous sulfate

Correct answer: C

Rationale: The correct answer is C, Valproic acid. Imipenem-cilastatin decreases the blood levels of valproic acid, an antiseizure medication, which can lead to increased seizure activity. Monitoring and adjusting the dosage of valproic acid may be necessary when co-administered with Imipenem-cilastatin to prevent adverse effects. Choices A, B, and D do not typically interact significantly with Imipenem-cilastatin and are not associated with a high risk of adverse interactions in this scenario.

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