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 has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?

• A. Orthostatic hypotension
• B. Increased heart rate
• C. Dark-colored urine
• D. Persistent cough

Correct answer: B

Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.

3. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication on an empty stomach.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.

4. A client is being taught about Terbutaline. Which statement by the client indicates understanding of the teaching?

• A. This medication will stop my contractions.
• B. This medication will prevent vaginal bleeding.
• C. This medication will promote blood flow to my baby.
• D. This medication will increase my prostaglandin production.

Correct answer: A

Rationale: The correct answer is A. Terbutaline works by blocking beta2-adrenergic receptors, leading to uterine smooth muscle relaxation and stopping contractions. Therefore, the client demonstrating understanding by recognizing that the medication will stop contractions is the most accurate response. Choices B, C, and D are incorrect because Terbutaline is primarily used to inhibit contractions in preterm labor, not prevent vaginal bleeding, promote blood flow to the baby, or increase prostaglandin production.

5. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

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