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 healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The healthcare provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old with no health problems
• B. 17-year-old with a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: A 17-year-old can be immunized for influenza with the LAIV via nasal spray. A hypersensitivity to penicillin is not a contraindication for an influenza immunization. Nasal spray influenza vaccine is generally recommended for healthy individuals between 2 and 49 years old. Choices A, C, and D are not candidates for nasal spray influenza vaccine. A 1-year-old is too young, pregnant individuals should not receive the nasal spray, and age is a factor for the use of the nasal spray vaccine.

3. A client is taking Paroxetine to treat PTSD and reports teeth grinding at night. Which interventions should the nurse implement to manage Bruxism? (Select all that apply.)

• A. Concurrent administration of buspirone.
• B. Administration of a different SSRI.
• C. Use of a mouth guard.
• D. Changing to a different class of antidepressant medication.

Correct answer: A

Rationale: The correct interventions to manage Bruxism associated with Paroxetine use include A: Concurrent administration of buspirone. Buspirone can help alleviate the side effect of Bruxism. Additionally, C: Use of a mouth guard is recommended to prevent oral damage from teeth grinding. B: Administration of a different SSRI is not necessary since the issue is specific to Paroxetine. D: Changing to a different class of antidepressant medication may be considered in severe cases, but the initial step should be to add buspirone to address the Bruxism caused by Paroxetine.

4. What is the classification for the drug valproate?

• A. Anti-diabetic
• B. Anti-convulsant
• C. Anti-ulcer agent
• D. Anti-hypertensive

Correct answer: B

Rationale: Valproate is classified as an anticonvulsant. It is commonly used to treat epilepsy and bipolar disorder by stabilizing electrical activity in the brain. Therefore, the correct classification for valproate is as an anticonvulsant. Options A, C, and D are incorrect because valproate is not used to treat diabetes, ulcers, or hypertension.

5. A client is prescribed gentamicin for 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 is a significant finding that can indicate nephrotoxicity, a potential adverse effect of gentamicin. Nephrotoxicity can lead to kidney damage, and monitoring for this adverse reaction is crucial during gentamicin therapy. Elevated blood pressure (Choice A) is not typically associated with gentamicin adverse reactions. Decreased urine output (Choice C) may suggest kidney impairment but is not as specific as the presence of red blood cells in the urine. Respiratory rate (Choice D) is not directly related to potential adverse reactions to gentamicin.

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