Nursing Elites

1. A client has a prescription for ceftriaxone. Which of the following information should the nurse include in the teaching?

• A. You may develop a cough while taking this medication.
• B. You should stop taking this medication if you develop a rash.
• C. This medication can be given orally.
• D. This medication may cause your urine to turn yellow.

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to discontinue ceftriaxone if a rash develops, as it could indicate an allergic reaction that needs to be reported to the healthcare provider for further evaluation and management. Choices A, C, and D are incorrect because cough development, oral administration, and yellow urine are not typically associated with ceftriaxone use and are not critical information that the nurse needs to emphasize in this scenario.

2. A client is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion?

• A. I signed up for a swimming class.
• B. I've been taking an antacid to help with indigestion.
• C. I've lost 2 pounds since my appointment 2 weeks ago.
• D. The naproxen is easier to take when I crush it and put it in applesauce.

Correct answer: B

Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion. This statement suggests potential gastrointestinal distress or interactions between the medications. Antacids can affect the absorption of naproxen or lead to other complications. Therefore, the nurse should address this statement with the client to ensure safe and effective medication management. Choices A, C, and D do not raise immediate concerns related to the client's medication regimen and can be considered positive health behaviors or side effects of treatment that do not require immediate intervention.

3. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.

4. When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril. Choices B, C, and D are incorrect because Lisinopril is typically taken once a day in the morning, it can lead to hyperkalemia (so increasing potassium-rich foods is not advised), and it can be taken with or without food.

5. A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?

• A. Skin test for allergy to the medication
• B. ECG to rule out cardiac dysrhythmias
• C. Mantoux test to rule out exposure to tuberculosis
• D. Liver function tests to assess risk for medication toxicity

Correct answer: A

Rationale: Before starting Calcitonin-salmon, it is important to assess for any potential allergies as anaphylaxis can occur. A skin test is usually conducted to determine if the client is allergic to the medication. The nurse should also inquire about any previous allergies to fish, as Calcitonin-salmon is derived from salmon. Options B, C, and D are not necessary before initiating Calcitonin-salmon therapy. ECG is not directly related to this medication, Mantoux test is used to diagnose tuberculosis, and liver function tests are not specifically required before starting Calcitonin-salmon.

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