Nursing Elites

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

• A. Take this medication with food.
• B. Avoid dairy products while taking this medication.
• C. Take this medication at bedtime.
• D. Increase your intake of vitamin C.

Correct answer: A

Rationale: Nitrofurantoin should be taken with food to enhance absorption and reduce gastrointestinal side effects. Taking it with a meal or a snack can help minimize stomach upset. Instructing the client to take the medication with food ensures optimal effectiveness and tolerability of the drug. Choice B is incorrect because there is no specific interaction between Nitrofurantoin and dairy products. Choice C is incorrect as there is no requirement to take Nitrofurantoin at bedtime. Choice D is also incorrect as increasing vitamin C intake is not necessary or relevant to taking Nitrofurantoin.

2. When a client is receiving treatment with methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Vitamin D
• C. Calcium
• D. Iron

Correct answer: A

Rationale: Folic acid supplementation is crucial for clients undergoing methotrexate treatment because methotrexate functions as a folic acid antagonist. By supplementing with folic acid, the risk of methotrexate toxicity can be minimized, improving the treatment's effectiveness and safety. Vitamin D, calcium, and iron are not specifically recommended in conjunction with methotrexate therapy and may not provide the same protective benefits as folic acid.

3. When teaching parents about a child newly prescribed Desipramine, the nurse should instruct them that which of the following adverse effects is the priority to report to the provider?

• A. Constipation
• B. Suicidal thoughts
• C. Photophobia
• D. Dry mouth

Correct answer: B

Rationale: The priority adverse effect to report when a child is prescribed Desipramine is suicidal thoughts. Desipramine can increase the risk of suicidal thoughts and behaviors. It is crucial for parents to monitor the child for any signs of worsening depression or thoughts of self-harm and report them promptly to the healthcare provider to prevent any harm to the child. Options A, C, and D are potential side effects of Desipramine but are not as urgent or life-threatening as suicidal thoughts, which require immediate intervention to ensure the safety of the child.

4. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

5. A patient is receiving spironolactone for heart failure. Which of the following findings should the nurse report to the provider?

• A. Hyperkalemia
• B. Hypernatremia
• C. Hyponatremia
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient. Choices B, C, and D are incorrect because spironolactone is not associated with hypernatremia, hyponatremia, or hypokalemia. Hyperkalemia is the critical finding that the nurse should report in a patient receiving spironolactone.

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