Nursing Elites

1. When teaching a client with a new prescription for Ipratropium, which of the following instructions should the nurse include?

• A. This medication can be used as a rescue inhaler.
• B. This medication should be taken before albuterol.
• C. Wait 5 minutes between medications if two inhaled medications are prescribed.
• D. Ipratropium can be used before exercise.

Correct answer: C

Rationale: When two inhaled medications are prescribed, waiting 5 minutes between medications allows for optimal absorption and effectiveness of each medication. This ensures that each medication can work properly without interference from the other, improving the client's respiratory condition.

2. When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril. Choices B, C, and D are incorrect because Lisinopril is typically taken once a day in the morning, it can lead to hyperkalemia (so increasing potassium-rich foods is not advised), and it can be taken with or without food.

3. Which drug is the antidote for Alprazolam?

• A. Physostigmine
• B. Protamine sulfate
• C. Flumazenil
• D. Acetylcysteine

Correct answer: C

Rationale: Flumazenil is the specific antidote used to reverse the effects of Alprazolam. Alprazolam is a benzodiazepine, and Flumazenil is a benzodiazepine receptor antagonist that works by competitively inhibiting the actions of benzodiazepines at the receptor site, effectively reversing their sedative and other effects. Physostigmine is not used as an antidote for benzodiazepine overdose and can have significant side effects. Protamine sulfate is used to reverse the effects of heparin, not benzodiazepines like Alprazolam. Acetylcysteine is used as an antidote for acetaminophen overdose, not benzodiazepines like Alprazolam.

4. When should Montelukast be taken?

• A. At least two hours before exercise
• B. Daily in the evening
• C. Two hours before exercise or daily in the evening
• D. None of the above

Correct answer: B

Rationale: Montelukast should be taken daily in the evening to effectively manage asthma symptoms. Taking it at the same time each day helps maintain a consistent level of the medication in the body, providing optimal control over asthma symptoms and inflammation. Choice A is incorrect because Montelukast should not be taken specifically before exercise, but rather daily. Choice C is incorrect because although taking Montelukast two hours before exercise is not necessary, taking it daily in the evening is essential for its effectiveness. Choice D is incorrect as Montelukast should be taken daily to manage asthma.

5. When teaching a client with a new prescription for Simvastatin, which instruction should be included?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for Simvastatin is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Simvastatin, leading to increased blood levels of the drug and a higher risk of adverse effects such as muscle pain and liver damage. It is important to educate the client about this potential interaction to ensure the safe and effective use of the medication. Choices A, C, and D are incorrect because taking Simvastatin with food or in the morning and increasing potassium-rich foods intake are not specifically related to the safe use of Simvastatin. Avoiding grapefruit juice is crucial to prevent drug interactions.

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