Nursing Elites

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

• A. Expect orange discoloration of urine and skin.
• B. Increase your intake of high-sodium foods.
• C. Take the medication with a full glass of milk.
• D. Expect your stools to be black and tarry.

Correct answer: A

Rationale: The correct instruction to include when teaching a client with a new prescription for Sulfasalazine is to expect orange discoloration of urine and skin. Sulfasalazine can cause this harmless side effect, which does not necessitate discontinuation of the medication. It is crucial for the nurse to educate the client about this expected outcome to prevent unnecessary concern or discontinuation of the medication. Choices B, C, and D are incorrect. Increasing intake of high-sodium foods is not recommended with Sulfasalazine, as it can worsen certain side effects. Taking the medication with a full glass of milk is not necessary for Sulfasalazine administration. Expecting stools to be black and tarry is not an expected side effect of Sulfasalazine.

2. A client has a new prescription for Nevirapine, an NNRTI. Which of the following statements should the nurse include in discharge teaching?

• A. Take this medication with food to increase absorption.
• B. Avoid alcohol while taking this medication.
• C. Take this medication at the same time every day.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: The correct statement to include in discharge teaching about Nevirapine, an NNRTI, is to advise the client to avoid alcohol while taking this medication. Alcohol can interact with Nevirapine and lead to potential adverse effects or decreased effectiveness. Choice A is incorrect because Nevirapine should be taken without food or on an empty stomach for optimal absorption. Choice C is a general recommendation for most medications but not specifically for Nevirapine. Choice D is incorrect as Nevirapine should not be taken on an empty stomach.

3. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, what advice should the nurse provide?

• A. Avoid using acetaminophen for headaches.
• B. Restrict intake of foods high in sodium.
• C. Decrease fluid intake to less than 1,500 mL daily.
• D. Limit aerobic activity in hot weather.

Correct answer: D

Rationale: The nurse should advise the client to limit aerobic activity in hot weather to prevent sodium/water depletion, which can increase the risk for Lithium toxicity. Excessive sweating and fluid loss can lead to dehydration and changes in lithium levels, potentially resulting in toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting sodium intake and decreasing fluid intake can lead to increased lithium levels and toxicity, so these are not recommended actions.

4. A client has a new prescription for spironolactone. The nurse should instruct the client to avoid which of the following foods?

• A. Salt substitutes
• B. Apples
• C. Chicken
• D. Bananas

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic. The client should avoid salt substitutes because they often contain potassium, which could lead to hyperkalemia. Hyperkalemia, or high levels of potassium in the blood, is a potential side effect of spironolactone, and ingesting additional potassium from salt substitutes can exacerbate this risk.

5. A client is receiving heparin therapy. Which laboratory value should be monitored by the nurse to evaluate the effectiveness of the therapy?

• A. PT
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The activated partial thromboplastin time (aPTT) is specifically used to monitor the effectiveness of heparin therapy. It should be maintained at 1.5 to 2 times the normal level. Monitoring aPTT helps ensure that the therapeutic range of heparin is achieved to prevent clot formation while minimizing the risk of bleeding complications. Choice A (PT) is incorrect as it is used to monitor warfarin therapy, not heparin. Choice C (INR) is also incorrect as it is primarily used to monitor warfarin therapy. Choice D (Platelet count) is not directly related to monitoring the effectiveness of heparin therapy.

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