Nursing Elites

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

• A. Avoid using a soft toothbrush.
• B. Avoid foods high in vitamin K.
• C. Report any signs of bleeding to your provider.
• D. Use an electric shaver for shaving.

Correct answer: C

Rationale: The correct statement the nurse should include when teaching a client with a new prescription for warfarin is to report any signs of bleeding to their provider. Bleeding can indicate excessive anticoagulation, a potential side effect of warfarin therapy that needs prompt medical attention. Choices A, B, and D are incorrect because while oral hygiene measures, dietary considerations, and skin care are important, they are not the priority when teaching a client about warfarin therapy. Monitoring for and reporting signs of bleeding is crucial due to the anticoagulant effects of warfarin.

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

• A. You should have a high-carbohydrate snack between meals and at bedtime.
• B. You are likely to develop hand tremors if you take this medication for a long period of time.
• C. You may experience temporary numbness of your mouth after each dose.
• D. You should have your white blood cell count monitored every week.

Correct answer: D

Rationale: Clozapine carries a risk for fatal agranulocytosis. To monitor for this serious adverse effect, it is crucial to check the client's white blood cell count weekly while they are on clozapine therapy.

3. A client is prescribed Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?

• A. Dry mouth
• B. Hypertension
• C. Excessive perspiration
• D. Fecal impaction

Correct answer: C

Rationale: Bethanechol is a muscarinic agonist, which stimulates muscarinic receptors. Activation of these receptors can lead to increased sweating (excessive perspiration) as a manifestation of muscarinic stimulation. Options A, B, and D are not typically associated with muscarinic stimulation. Dry mouth is a common side effect of anticholinergic medications, hypertension is not a common manifestation of muscarinic stimulation, and fecal impaction is not directly related to muscarinic receptor activation.

4. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

• A. A client at 8 weeks of gestation who asks for an Influenza immunization
• B. A client who takes Prednisone and has a possible Fungal infection
• C. A client who has chronic liver disease and is taking Hydrocodone
• D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide

Correct answer: B

Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.

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

• A. This medication may cause dry mouth.
• B. You should avoid drinking grapefruit juice.
• C. You may experience a rapid heart rate.
• D. Increase your intake of fiber-rich foods.

Correct answer: B

Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.

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