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. When reviewing a client's health record, a nurse notes a new prescription for Lisinopril 10 mg PO once daily. The nurse should identify this as which type of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates medications to be administered on a regular schedule without a termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily falls under a routine prescription, meaning the nurse will administer this medication daily until the provider discontinues it. Choices A, B, and D are incorrect: A 'single' prescription is for a one-time dose, 'stat' prescriptions are for immediate administration, and 'standing' prescriptions are pre-authorized for administration as needed within specified parameters.

3. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

4. A client has a new prescription for Captopril. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Increase your intake of sodium-rich foods.

Correct answer: C

Rationale: Captopril should be taken on an empty stomach for better absorption. The client should be instructed to take it 1 hour before or 2 hours after meals to optimize its effectiveness. Taking it with food can reduce its absorption and efficacy.

5. When educating a client starting a new prescription for metoprolol, which instruction should the nurse include?

• A. Check your pulse before taking the medication.
• B. Take the medication with food to increase absorption.
• C. Avoid sudden changes in position.
• D. Monitor your blood pressure regularly.

Correct answer: C

Rationale: The correct instruction for a client starting metoprolol is to avoid sudden changes in position. Metoprolol can cause dizziness due to its blood pressure-lowering effects, increasing the risk of falls and injury. Instructing the client to change positions slowly helps prevent orthostatic hypotension and related adverse events. Checking the pulse before taking the medication (Choice A) is not typically necessary for metoprolol. Taking the medication with food (Choice B) is not required for absorption and can be taken with or without food. Monitoring blood pressure regularly (Choice D) is essential for clients taking metoprolol, but avoiding sudden changes in position is more critical to prevent dizziness and falls.

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