Nursing Elites

1. A client has a new prescription for Cyanocobalamin (Vitamin B12) injections. Which of the following client statements indicates an understanding of the teaching?

• A. I will need to take this medication for the rest of my life.
• B. I will stop taking the medication when my symptoms improve.
• C. I should take this medication with food.
• D. I will need to avoid green, leafy vegetables while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Clients with pernicious anemia or other causes of vitamin B12 deficiency may need to take cyanocobalamin for life to prevent deficiency. It is a lifelong treatment in many cases to maintain adequate B12 levels. Choice B is incorrect because stopping the medication when symptoms improve may lead to a relapse of the deficiency. Choice C is incorrect as cyanocobalamin injections are usually administered on an empty stomach. Choice D is incorrect as there is no need to avoid green, leafy vegetables while taking cyanocobalamin; in fact, these vegetables are good dietary sources of vitamin B12.

2. A healthcare professional reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the professional take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication, and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments. Choice B is incorrect because waiting 24 hours after taking the medication would not provide an accurate trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect because obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level, as it is the lowest concentration before the next dose.

3. Which of the following drugs has a therapeutic effect that prevents thromboembolic events?

• A. Warfarin
• B. Amlodipine
• C. Nitroglycerin
• D. Clopidogrel

Correct answer: A

Rationale: The correct answer is Warfarin. Warfarin is an anticoagulant medication that helps prevent thromboembolic events by inhibiting the formation of blood clots. It is commonly used to reduce the risk of strokes or heart attacks in patients at risk for thrombosis.

4. When educating a client who has a new prescription for Levothyroxine to treat hypothyroidism, which of the following instructions should be included?

• A. Take the medication first thing in the morning before eating.
• B. Take the medication at bedtime to avoid drowsiness.
• C. Take the medication with food to prevent nausea.
• D. Take the medication with a glass of milk.

Correct answer: A

Rationale: Levothyroxine should be taken first thing in the morning before eating to ensure optimal absorption. Taking it on an empty stomach helps prevent interactions with food or other medications that may decrease its effectiveness. It is important to follow this timing recommendation to maintain consistent thyroid hormone levels in the body. Choice B is incorrect as taking Levothyroxine at bedtime may lead to inconsistent absorption and affect its efficacy. Choice C is incorrect because taking Levothyroxine with food can interfere with its absorption. Choice D is incorrect as Levothyroxine should be taken with a full glass of water, not milk, to aid in proper absorption.

5. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

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