Nursing Elites

1. A client has a new prescription for Dabigatran. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Store the capsules in a pill organizer.
• C. Crush the medication before swallowing.
• D. Expect frequent headaches while taking this medication.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with food.' Taking Dabigatran with food is recommended to reduce gastrointestinal discomfort, a common side effect associated with this medication. Food can help minimize stomach irritation and improve tolerability. Choices B, C, and D are incorrect. Storing the capsules in a pill organizer (B) is a good practice for organization but not a specific instruction for this medication. Crushing the medication before swallowing (C) is not recommended for Dabigatran as it is available as a capsule and should be swallowed whole. Expecting frequent headaches while taking this medication (D) is not a common side effect of Dabigatran and should not be anticipated.

2. A healthcare professional is preparing to administer a transfusion of 300 mL of pooled platelets for a client who has severe Thrombocytopenia. How long should the healthcare professional plan to administer the transfusion over?

• A. Within 30 min/unit
• B. Within 60 min/unit
• C. Within 2 hr/unit
• D. Within 4 hr/unit

Correct answer: A

Rationale: Platelets are fragile components that must be administered quickly to maintain their effectiveness and minimize the risk of clumping. The recommended administration time for platelets is within 15 to 30 minutes per unit. This rapid administration helps ensure the platelets remain viable and functional for the client receiving the transfusion. Therefore, the correct answer is to administer the transfusion within 30 minutes per unit. Choices B, C, and D are incorrect as they exceed the recommended administration time for platelets, which could compromise their efficacy and pose risks to the client.

3. While providing teaching to a client with a new prescription for Enalapril, the nurse should instruct the client to report which of the following manifestations as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: The correct answer is 'B: Dry cough.' Enalapril is an ACE inhibitor known to cause a persistent dry cough as a common adverse effect. This cough should be reported to the healthcare provider for further evaluation, as it may indicate a potential issue with the medication that needs attention to ensure the client's well-being. Tremors (Choice A), drowsiness (Choice C), and hyperactivity (Choice D) are not typically associated with Enalapril use. Therefore, they are incorrect choices for this question.

4. A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?

• A. Taking four medications decreases the risk of a severe allergic reaction.
• B. Taking four medications reduces the chance that the bacteria will become resistant.
• C. Taking four medications reduces the risk of adverse reactions.
• D. Taking four medications decreases the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: When treating tuberculosis, using a combination of multiple medications is crucial to reduce the risk of bacterial resistance. The use of four medications helps to target the bacteria from different angles, making it harder for them to develop resistance to the treatment. This approach is essential to ensure the effectiveness of the treatment regimen and to prevent the spread of drug-resistant strains of tuberculosis. Choices A, C, and D are incorrect because the primary reason for using multiple medications in tuberculosis treatment is to prevent the development of bacterial resistance, not to decrease the risk of allergic reactions, adverse reactions, or affecting the tuberculin skin test results.

5. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

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