Nursing Elites

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

• A. Take the medication with a full glass of water.
• B. Expect results within 30 minutes.
• C. Take this medication at bedtime.
• D. Avoid taking this medication with food.

Correct answer: A

Rationale: The correct instruction for a client prescribed Docusate Sodium is to take the medication with a full glass of water. Docusate sodium is a stool softener, and taking it with water helps to soften the stool and make bowel movements easier. Adequate fluid intake is crucial when taking stool softeners to prevent constipation. Choices B, C, and D are incorrect. B is incorrect because the effects of Docusate Sodium may not be immediate, and it may take a couple of days for the stool softener to work. Choice C is incorrect as there is no specific requirement to take this medication at bedtime. Choice D is incorrect because there is no instruction to avoid taking Docusate Sodium with food.

2. What is a serious adverse reaction to penicillin?

• A. Liver Failure
• B. Anaphylaxis
• C. Respiratory Depression
• D. Edema

Correct answer: B

Rationale: The correct answer is B: Anaphylaxis. Anaphylaxis is a severe allergic reaction that can occur as a serious adverse reaction to penicillin. It is a life-threatening condition that requires immediate medical attention. Choices A, C, and D are incorrect. Liver failure is not a typical adverse reaction to penicillin, respiratory depression is more commonly associated with opioid medications, and edema is not a common severe adverse reaction to penicillin.

3. A client with thrombophlebitis receiving heparin by continuous IV infusion asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

• A. It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.
• B. A pharmacist is the person to answer that question.
• C. Heparin does not dissolve clots. It stops new clots from forming.
• D. The oral medication you will take after this IV will dissolve the clot.

Correct answer: C

Rationale: The correct response is C. Heparin does not dissolve clots; it prevents new clots from forming. Heparin works by inhibiting the formation of new clots and the extension of existing clots, rather than directly dissolving them. The client should be informed that the purpose of heparin therapy is to prevent the clot from getting larger and to reduce the risk of new clots forming. Choices A, B, and D are incorrect. Choice A talks about reaching a therapeutic blood level of heparin, which is not related to clot dissolution. Choice B deflects the question to a pharmacist without providing relevant information. Choice D inaccurately suggests that an oral medication will dissolve the clot, which is not the mechanism of action for heparin.

4. 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.

5. Which adverse reaction poses the greatest life-threatening risk when taking Omeprazole?

• A. Chest pain
• B. Constipation
• C. Clostridium difficile-associated diarrhea
• D. Acute interstitial nephritis

Correct answer: C

Rationale: The most life-threatening adverse reaction associated with Omeprazole is Clostridium difficile-associated diarrhea. This condition can be severe and life-threatening due to the potential for dehydration, electrolyte imbalances, and complications such as toxic megacolon. Chest pain, constipation, and acute interstitial nephritis are potential side effects of Omeprazole but are not considered as life-threatening as Clostridium difficile-associated diarrhea. Monitoring for signs of this adverse reaction is crucial, and immediate medical attention should be sought if symptoms develop.

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