Nursing Elites

1. A client has a new prescription for Metronidazole to treat an infection. Which of the following instructions should the nurse include?

• A. Avoid alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Increase your intake of dairy products while taking this medication.
• D. Avoid direct sunlight while taking this medication.

Correct answer: A

Rationale: The correct instruction is to avoid alcohol while taking Metronidazole. This is crucial to prevent a disulfiram-like reaction, which can result in severe nausea and vomiting. Alcohol should be avoided for at least 48 hours after completing the medication course as well. Choice B is incorrect because Metronidazole can be taken with food to reduce gastrointestinal side effects. Choice C is incorrect because there is no need to increase dairy product intake while on Metronidazole. Choice D is incorrect because there is no specific instruction to avoid direct sunlight while taking this medication.

2. A client is taking Sucralfate PO for Peptic Ulcer Disease and has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

• A. Take an antacid with the sucralfate.
• B. Take sucralfate with a glass of milk.
• C. Allow a 2-hour interval between these medications.
• D. Chew the sucralfate thoroughly before swallowing.

Correct answer: C

Rationale: Sucralfate can interfere with the absorption of phenytoin. To prevent this interaction, the client should allow a 2-hour interval between taking sucralfate and phenytoin. This timing helps to ensure adequate absorption and effectiveness of both medications without compromising therapeutic outcomes. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, and chewing sucralfate thoroughly before swallowing do not address the need for a 2-hour interval between these medications to prevent interference with phenytoin absorption.

3. A client has a new prescription for Alteplase. Which of the following actions should the nurse plan to take?

• A. Administer the medication within 4 hours of the onset of symptoms.
• B. Reconstitute the medication with sterile saline.
• C. Administer heparin concurrently with the Alteplase infusion.
• D. Monitor for changes in level of consciousness.

Correct answer: D

Rationale: Alteplase is a thrombolytic agent used to dissolve blood clots. Patients receiving Alteplase are at risk for bleeding complications, including intracranial bleeding. Monitoring for changes in the level of consciousness is crucial as it can indicate early signs of bleeding, such as increased intracranial pressure. This rapid assessment allows for timely intervention and prevention of further complications. Choices A, B, and C are incorrect. Administering Alteplase within 4 hours of symptom onset is related to the time-sensitive nature of thrombolytic therapy for conditions like acute myocardial infarction or ischemic stroke. Reconstituting Alteplase with sterile saline is a correct step in preparing the medication for administration. Administering heparin concurrently with Alteplase is generally avoided due to the increased risk of bleeding.

4. A client with a prescription for Vasopressin to treat Diabetes Insipidus is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I will reduce my sodium intake.
• B. I should increase my water intake.
• C. I will notify my doctor if I develop chest pain.
• D. I should take this medication with food.

Correct answer: C

Rationale: The correct answer is C because Vasopressin can cause vasoconstriction, potentially leading to chest pain. It is crucial for the client to inform their healthcare provider immediately if they experience chest pain while on Vasopressin therapy to address any potential cardiovascular complications promptly. Choices A, B, and D are incorrect. While maintaining adequate hydration is essential with Vasopressin therapy due to its antidiuretic effect, increasing water intake is not the most critical aspect to monitor. Reducing sodium intake may be beneficial in some cases but is not directly related to the potential side effects of Vasopressin. Taking the medication with food is not a specific instruction for Vasopressin administration.

5. A client is prescribed levothyroxine for hypothyroidism. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Decreased heart rate
• B. Increased energy levels
• C. Weight loss
• D. Improved mental clarity

Correct answer: B

Rationale: Increased energy levels are a key indicator of the effectiveness of levothyroxine in treating hypothyroidism. Levothyroxine works to regulate thyroid hormone levels, which can lead to improved energy levels as the body's metabolism is restored. While the other options may also improve with treatment, increased energy levels directly reflect the correction of the thyroid hormone imbalance. Decreased heart rate can be an indicator of overmedication, weight loss can be attributed to increased metabolism but may not directly reflect the effectiveness of levothyroxine, and improved mental clarity is a more general cognitive improvement that may not directly relate to thyroid function.

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