Nursing Elites

1. A client has a new prescription for Ranitidine to treat peptic ulcer disease. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid smoking while taking this medication.
• C. Increase intake of dairy products.
• D. Expect a yellow tinge to the skin.

Correct answer: B

Rationale: The correct instruction that the nurse should include for a client prescribed Ranitidine to treat peptic ulcer disease is to avoid smoking while taking the medication. Smoking can interfere with the effectiveness of ranitidine and worsen ulcer symptoms. Therefore, it is crucial for clients to abstain from smoking to ensure optimal therapeutic outcomes. Choices A, C, and D are incorrect. Taking Ranitidine with or without food does not significantly affect its effectiveness, there is no specific need to increase intake of dairy products, and expecting a yellow tinge to the skin is not a common side effect associated with Ranitidine.

2. A healthcare professional is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare professional plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 min.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hr of manifestation onset.

Correct answer: B

Rationale: The correct intervention when administering IV Alteplase is to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This helps prevent bleeding complications associated with thrombolytic therapy. Administering IM Enoxaparin is not indicated with Alteplase, as it is an anticoagulant rather than a thrombolytic agent. Aminocaproic acid is not typically administered prior to alteplase infusion in the context of a massive Pulmonary Embolism. While timely administration of Alteplase is important, the specific timeframe within which it should be administered may vary based on the clinical situation, so a strict 8-hour window is not universally applicable.

3. A client is starting Simvastatin. Which of the following information should be included in the teaching?

• A. Take this medication in the evening.
• B. Change positions slowly when rising from a chair.
• C. Maintain a steady intake of green leafy vegetables.
• D. Consume no more than 1 L/day of fluid.

Correct answer: A

Rationale: The correct answer is to take simvastatin in the evening. This timing is recommended because nighttime is when the most cholesterol is synthesized in the body. By taking statin medications in the evening, it can enhance their effectiveness in reducing cholesterol levels.

4. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?

• A. Metformin
• B. Metoprolol
• C. Lisinopril
• D. Insulin

Correct answer: A

Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.

5. When caring for a school-age child with a new prescription for Atomoxetine, the nurse should monitor the client for which of the following adverse effects of this medication?

• A. Kidney toxicity
• B. Liver damage
• C. Seizure activity
• D. Adrenal insufficiency

Correct answer: B

Rationale: The correct answer is B: Liver damage. Atomoxetine can lead to liver damage as an adverse effect. Symptoms of liver damage include jaundice, upper abdominal tenderness, dark urine, and elevated liver enzymes. Monitoring for these signs is crucial when a child is on this medication. Choices A, C, and D are incorrect because Atomoxetine is not known to cause kidney toxicity, seizure activity, or adrenal insufficiency as primary adverse effects.

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