Nursing Elites

1. A healthcare provider is educating a client who has a prescription for Theophylline. Which of the following instructions should the healthcare provider include?

• A. Avoid caffeine while taking this medication.
• B. You should increase your fluid intake.
• C. Take this medication in the evening.
• D. You may experience increased appetite while on this medication.

Correct answer: A

Rationale: The correct answer is A: 'Avoid caffeine while taking this medication.' Caffeine can increase the risk of theophylline toxicity as it competes for the same metabolic pathways. Consuming caffeine while on theophylline can lead to adverse effects. Choice B is incorrect because although maintaining adequate hydration is important, it is not a specific instruction related to theophylline use. Choice C is incorrect as the timing of the medication administration should be based on the healthcare provider's recommendation and the client's individual needs. Choice D is incorrect as increased appetite is not a common side effect associated with theophylline.

2. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.

3. A client has a new prescription for Tetracycline. Which of the following instructions should be included?

• A. Take the medication with milk.
• B. Avoid prolonged sun exposure.
• C. Take the medication at bedtime.
• D. Expect urine to turn dark yellow.

Correct answer: B

Rationale: The correct instruction to include for a client prescribed Tetracycline is to 'Avoid prolonged sun exposure.' Tetracycline can cause photosensitivity, making the client more sensitive to the sun's rays. This can lead to adverse reactions like sunburn or skin rashes. Therefore, it is crucial for the client to minimize sun exposure and wear protective clothing when outdoors. Choice A is incorrect because taking Tetracycline with milk can reduce its absorption. Choice C is incorrect as there is no specific requirement to take Tetracycline at bedtime. Choice D is also incorrect as Tetracycline does not typically cause dark yellow urine.

4. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: The client's symptoms of face spasms after receiving Prochlorperazine indicate acute dystonia, a known side effect. Diphenhydramine is commonly administered to manage extrapyramidal symptoms, such as muscle spasms, caused by medications like Prochlorperazine. Therefore, the nurse should anticipate a prescription for Diphenhydramine to alleviate the client's symptoms. Choices A, B, and C are incorrect because Fomepizole is used in methanol or ethylene glycol poisoning, Naloxone is an opioid antagonist used in opioid overdose, and Phytonadione is vitamin K, used to reverse the effects of certain blood thinners.

5. A client is prescribed an IM dose of penicillin. The client reports developing a rash after taking penicillin 3 years ago. What should the nurse do?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The nurse should withhold the medication and inform the provider of the client's previous rash after taking penicillin. This history suggests a potential allergic reaction to penicillin, which can range from mild to severe anaphylaxis. Notifying the provider allows for an alternative antibiotic to be prescribed, considering the client's allergy to penicillin. It is crucial to avoid administering a medication that could potentially lead to a severe allergic reaction in the client. Administering the prescribed dose (Choice A) could be harmful due to the potential for an allergic reaction. Changing the prescription to an oral form (Choice C) does not address the underlying issue of a potential penicillin allergy. Administering an oral antihistamine (Choice D) without consulting the provider may not be sufficient to prevent a severe allergic reaction.

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