Nursing Elites

1. A client has a new prescription for Diltiazem. Which of the following statements should the nurse include in the teaching?

• A. This medication may cause dry mouth.
• B. You should avoid drinking grapefruit juice.
• C. You may experience a rapid heart rate.
• D. Increase your intake of fiber-rich foods.

Correct answer: B

Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.

2. A client has a prescription for Nitroglycerin. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin involves taking one tablet at the onset of chest pain, then another tablet every 5 minutes for up to three doses. This protocol aims to relieve angina symptoms. Choice A is incorrect because waiting 15 minutes between doses may delay symptom relief. Choice C is incorrect as Nitroglycerin is not typically taken at bedtime but rather during angina episodes. Choice D is incorrect because Nitroglycerin is usually taken sublingually, so it doesn't need to be taken on an empty stomach.

3. A client is receiving heparin therapy. Which laboratory value should be monitored by the nurse to evaluate the effectiveness of the therapy?

• A. PT
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The activated partial thromboplastin time (aPTT) is specifically used to monitor the effectiveness of heparin therapy. It should be maintained at 1.5 to 2 times the normal level. Monitoring aPTT helps ensure that the therapeutic range of heparin is achieved to prevent clot formation while minimizing the risk of bleeding complications. Choice A (PT) is incorrect as it is used to monitor warfarin therapy, not heparin. Choice C (INR) is also incorrect as it is primarily used to monitor warfarin therapy. Choice D (Platelet count) is not directly related to monitoring the effectiveness of heparin therapy.

4. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

• A. A client at 8 weeks of gestation who asks for an Influenza immunization
• B. A client who takes Prednisone and has a possible Fungal infection
• C. A client who has chronic liver disease and is taking Hydrocodone
• D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide

Correct answer: B

Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.

5. Which of the following conditions is not typically treated with Hydrochlorothiazide?

• A. CHF
• B. HTN
• C. Nephritis
• D. Hypercalciuria

Correct answer: C

Rationale: Nephritis is not commonly treated with Hydrochlorothiazide. Hydrochlorothiazide is primarily used for managing hypertension (HTN) and congestive heart failure (CHF) by reducing blood pressure and fluid retention. It is not a standard treatment for nephritis, which involves inflammation of the kidneys. Hypercalciuria, characterized by excessive calcium excretion in the urine, is not typically treated with Hydrochlorothiazide either.

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