Nursing Elites

1. A client has a prescription for Trimethoprim-Sulfamethoxazole. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Increase fluid intake.
• C. Expect reddish-orange urine.
• D. Avoid high-protein foods.

Correct answer: B

Rationale: The correct instruction for a client prescribed Trimethoprim-Sulfamethoxazole is to increase fluid intake. This helps prevent crystalluria and kidney stones, which are potential adverse effects of this medication. Adequate hydration is essential to reduce the risk of these complications.

2. A client is starting to take amitriptyline. The healthcare provider should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Urinary retention
• C. Bradycardia
• D. Dry cough

Correct answer: B

Rationale: The correct answer is B: Urinary retention. Amitriptyline, a tricyclic antidepressant, can cause relaxation of the bladder sphincter muscles, leading to urinary retention. Monitoring for urinary retention is crucial as it is a common anticholinergic effect associated with this medication. Diarrhea (choice A) is not a common adverse effect of amitriptyline. Bradycardia (choice C) is more commonly associated with beta-blockers rather than tricyclic antidepressants like amitriptyline. Dry cough (choice D) is not a typical adverse effect of amitriptyline.

3. Which of the following conditions is not treated with Lansoprazole?

• A. Zollinger-Ellison syndrome
• B. Gastritis
• C. Hypertension
• D. Reflux

Correct answer: C

Rationale: Lansoprazole is a proton pump inhibitor used to treat conditions related to excessive stomach acid production, such as Zollinger-Ellison syndrome, gastritis, and reflux. However, it is not indicated for the treatment of hypertension, which is managed using antihypertensive medications. Therefore, the correct answer is C: Hypertension.

4. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

• A. Contact the provider if the heart rate is less than 60/min.
• B. Check the pulse rate for 30 seconds and multiply the result by 2.
• C. Increase the intake of sodium.
• D. Take with food if nausea occurs.

Correct answer: A

Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.

5. A client receiving chemotherapy reports nausea and vomiting. Which of the following medications should the nurse anticipate administering?

• A. Ondansetron
• B. Metoclopramide
• C. Promethazine
• D. Lorazepam

Correct answer: A

Rationale: The correct answer is A: Ondansetron. Ondansetron is a commonly used antiemetic for managing nausea and vomiting in clients undergoing chemotherapy. It works by blocking serotonin to reduce these symptoms effectively. Metoclopramide (choice B) is another antiemetic but is more commonly used for gastric motility disorders. Promethazine (choice C) is an antihistamine with antiemetic properties, but ondansetron is often preferred for chemotherapy-induced nausea and vomiting due to its efficacy and fewer side effects. Lorazepam (choice D) is a benzodiazepine used for anxiety and insomnia, not typically for managing nausea and vomiting in this context.

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