Nursing Elites

1. A client has a new prescription for Raltegravir. Which of the following statements should the nurse include in teaching the client?

• A. This medication prevents the virus from entering the cell.
• B. This medication prevents the virus from leaving the cell.
• C. This medication blocks the virus from attaching to the cell.
• D. This medication blocks the virus from replicating in the cell.

Correct answer: D

Rationale: The correct answer is D because Raltegravir works by blocking the integrase enzyme, preventing the virus from integrating its genetic material into the host cell's DNA. By inhibiting this process, viral replication within the host cell is halted. Choices A, B, and C are incorrect because Raltegravir's mechanism of action specifically targets viral replication within the cell, not virus entry, exit, or attachment to the cell.

2. 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.

3. When teaching a client with a new prescription for Amiodarone, which instruction should the nurse include?

• A. Take this medication with meals.
• B. Avoid drinking grapefruit juice.
• C. Take this medication at bedtime.
• D. Increase your intake of sodium-rich foods.

Correct answer: B

Rationale: The correct instruction is to avoid drinking grapefruit juice when taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the drug and potentially causing adverse effects like cardiac toxicity. Choices A, C, and D are incorrect because taking Amiodarone with meals, at bedtime, or increasing sodium-rich foods intake are not relevant instructions for this medication.

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: The correct answer is C, Regular insulin. Regular insulin, also known as short-acting insulin, typically exhibits a peak effect around 1 to 5 hours following administration. This rapid onset and peak effect make it suitable for managing postprandial glucose levels. Insulin glargine is a long-acting insulin with no pronounced peak effect, making it unsuitable for rapid glucose control within 1 to 5 hours. NPH insulin has an intermediate duration of action and a different peak time frame. Insulin lispro is a rapid-acting insulin that peaks within 30 minutes to 2.5 hours after administration, not within the 1 to 5-hour range.

5. A client with Angina Pectoris asks the nurse about the next step if one tablet does not relieve Anginal pain after waiting 5 minutes. Which of the following responses should the nurse make?

• A. Take two more sublingual tablets simultaneously.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes before taking a second sublingual tablet.

Correct answer: B

Rationale: In a situation where Anginal pain persists after taking one sublingual tablet and waiting 5 minutes, it is crucial to call emergency services (911) immediately. This could indicate a myocardial infarction (heart attack) rather than a typical Anginal attack. The client should not take two more sublingual tablets simultaneously without seeking immediate medical help as this could delay appropriate intervention if the pain is due to a heart attack. Taking a sustained-release nitroglycerin capsule is not recommended for immediate relief of acute Anginal pain as it works too slowly. Waiting another 5 minutes before taking a second sublingual tablet is not appropriate if the pain persists, as prompt action is essential in suspected heart-related issues.

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