Nursing Elites

1. When teaching a client with a new prescription for Simvastatin, which instruction should be included?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for Simvastatin is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Simvastatin, leading to increased blood levels of the drug and a higher risk of adverse effects such as muscle pain and liver damage. It is important to educate the client about this potential interaction to ensure the safe and effective use of the medication. Choices A, C, and D are incorrect because taking Simvastatin with food or in the morning and increasing potassium-rich foods intake are not specifically related to the safe use of Simvastatin. Avoiding grapefruit juice is crucial to prevent drug interactions.

2. 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.

3. A client has a prescription for gentamicin for the treatment of an infection. Which finding indicates a potential adverse reaction to the medication?

• A. Blood pressure 160/90 mm Hg
• B. Presence of red blood cells in the urine
• C. Urine output of 35 mL/hr
• D. Respiratory rate of 22/min

Correct answer: B

Rationale: The presence of red blood cells in the urine can indicate nephrotoxicity, which is a potential adverse effect of gentamicin. Gentamicin can cause damage to the kidneys, leading to the presence of red blood cells in the urine as a sign of renal impairment. Monitoring for this finding is crucial to detect and manage adverse reactions promptly. High blood pressure (Choice A) is not typically associated with gentamicin use. Low urine output (Choice C) is more suggestive of kidney injury rather than nephrotoxicity specifically related to gentamicin. Respiratory rate (Choice D) is not a common indicator of adverse reactions to gentamicin.

4. A client has a prescription for Amoxicillin. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Avoid taking the medication with milk.
• C. Expect your stools to turn clay-colored.
• D. Complete the entire course of therapy.

Correct answer: D

Rationale: The correct answer is D: Complete the entire course of therapy. It is crucial for clients to complete the entire course of amoxicillin therapy to ensure the infection is fully treated and to prevent antibiotic resistance. Prematurely stopping the antibiotic can lead to incomplete eradication of the infection, potentially causing it to return and be more difficult to treat. Choices A and B are not specific to amoxicillin and are general medication administration instructions. Choice C is not a common side effect of amoxicillin and does not require patient education.

5. A client has a new prescription for Pancrelipase for chronic pancreatitis. Which of the following instructions should be included by the nurse?

• A. Take the medication with meals and snacks.
• B. Chew the tablet thoroughly before swallowing.
• C. Take the medication 1 hour before meals.
• D. Expect the stool to be yellow.

Correct answer: A

Rationale: The correct instruction for taking Pancrelipase is to take it with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This helps optimize the effectiveness of the medication in managing chronic pancreatitis. Choice B is incorrect because Pancrelipase should not be chewed but swallowed whole. Choice C is incorrect as the medication should be taken with meals. Choice D is incorrect because while Pancrelipase can cause stool changes, yellow stool is not an expected outcome.

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