Nursing Elites

1. A nurse is teaching a client who has breast cancer about the adverse effects of chemotherapy. Which of the following statements should the nurse include?

• A. You should use a soft-bristled toothbrush to prevent bleeding.'
• B. You should take aspirin for minor aches and pains.'
• C. You should avoid contact with individuals who recently received live virus vaccines.'
• D. You should consume a diet low in protein to reduce the risk of renal damage.'

Correct answer: A

Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia.

2. When teaching a client with a prescription for Cephalexin, which of the following instructions should the nurse include?

• A. Take the medication with an antacid.
• B. Avoid dairy products while taking this medication.
• C. Expect your stools to turn black.
• D. Complete the full course of medication.

Correct answer: D

Rationale: The correct instruction for a client prescribed with Cephalexin is to complete the full course of medication. This is crucial to ensure the infection is completely treated and to reduce the risk of antibiotic resistance. Choices A, B, and C are incorrect. Taking Cephalexin with an antacid is generally not recommended as it may reduce its effectiveness. While dairy products can interfere with certain antibiotics, they do not have a direct interaction with Cephalexin. Stools turning black is not an expected side effect of Cephalexin.

3. A client with thrombophlebitis receiving heparin by continuous IV infusion asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

• A. It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.
• B. A pharmacist is the person to answer that question.
• C. Heparin does not dissolve clots. It stops new clots from forming.
• D. The oral medication you will take after this IV will dissolve the clot.

Correct answer: C

Rationale: The correct response is C. Heparin does not dissolve clots; it prevents new clots from forming. Heparin works by inhibiting the formation of new clots and the extension of existing clots, rather than directly dissolving them. The client should be informed that the purpose of heparin therapy is to prevent the clot from getting larger and to reduce the risk of new clots forming. Choices A, B, and D are incorrect. Choice A talks about reaching a therapeutic blood level of heparin, which is not related to clot dissolution. Choice B deflects the question to a pharmacist without providing relevant information. Choice D inaccurately suggests that an oral medication will dissolve the clot, which is not the mechanism of action for heparin.

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

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: The correct answer is to instruct the client to notify the provider if they develop a persistent cough. A persistent cough is a common adverse effect of Captopril and other ACE inhibitors. It is essential for the client to inform their healthcare provider promptly if this side effect occurs, as it may indicate a potentially serious issue that needs medical attention.

5. A client has a new prescription for combination oral NRTIs for the treatment of HIV. Which of the following statements should the nurse include in discharge teaching?

• A. These medications work by inhibiting enzymes to prevent HIV replication.
• B. These medications work by preventing protein synthesis within the HIV cell.
• C. These medications work by weakening the cell wall of the HIV virus.
• D. These medications work by blocking HIV entry into cells.

Correct answer: A

Rationale: The correct answer is A. NRTI antiretroviral medications inhibit the enzyme reverse transcriptase, which is essential for HIV replication. By blocking this enzyme, the medications prevent the virus from replicating and spreading. This mechanism of action helps to control the progression of HIV infection in the body. Choices B, C, and D are incorrect because NRTIs do not work by preventing protein synthesis, weakening the cell wall of the virus, or blocking HIV entry into cells. These mechanisms are associated with different classes of antiretroviral medications used in HIV treatment.

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