Nursing Elites

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

• A. Increase your intake of vitamin D.
• B. Take this medication on an empty stomach.
• C. Avoid drinking grapefruit juice.
• D. Take this medication every other day.

Correct answer: A

Rationale: When a client is prescribed Prednisone, it is important to increase the intake of vitamin D to help mitigate the risk of bone loss associated with the medication. Vitamin D aids in calcium absorption, supporting bone health in individuals taking Prednisone.

2. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?

• A. Clopidogrel (Plavix)
• B. Morphine
• C. Aspirin (ASA)
• D. Metoprolol (Lopressor)

Correct answer: A

Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.

3. How should the oral form of albuterol be taken?

• A. Administer with meals to minimize gastric irritation
• B. Administer before meals with water
• C. Administer after meals with water
• D. Administer in the morning with milk

Correct answer: A

Rationale: The correct way to take oral albuterol is with meals to minimize gastric irritation. Taking it with food can help reduce the risk of stomach upset that may occur when the medication is taken on an empty stomach. This approach can improve tolerability and adherence to the treatment regimen. Choices B, C, and D are incorrect because taking albuterol before meals, after meals, or in the morning with milk does not address the issue of minimizing gastric irritation, which is a common side effect of the medication.

4. 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.

5. A client is receiving discharge instructions for a new prescription of Enoxaparin. Which of the following instructions should the provider include?

• A. Inject the medication into the muscle.
• B. Massage the injection site after administration.
• C. Rotate injection sites between the arms and thighs.
• D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct answer is to administer the medication in the abdomen. Enoxaparin is administered as a subcutaneous injection in the abdomen to prevent bleeding complications. Injecting into the muscle or massaging the site can increase the risk of bleeding. Rotating sites between the arms and thighs is not recommended for Enoxaparin administration due to variations in absorption rates. Therefore, the provider should instruct the client to administer Enoxaparin in the abdomen for optimal effectiveness and safety.

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