Nursing Elites

1. When teaching a client with cancer who has a prescription for methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Magnesium
• C. Vitamin D
• D. Iron

Correct answer: A

Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, so instructing the client to take folic acid helps reduce the risk of methotrexate toxicity by providing additional folic acid that the medication may deplete. Magnesium (choice B), Vitamin D (choice C), and Iron (choice D) are not the correct supplements to instruct the client to take with methotrexate.

2. A client reports taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. When used for more than 5 days, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion, which is an adverse effect to be assessed in the client. Sedation (choice A) is not a common adverse effect of phenylephrine. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with phenylephrine use.

3. A client with a new prescription for Escitalopram for the treatment of generalized anxiety disorder is being taught by a healthcare provider. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication on an empty stomach.
• B. I will follow a low-sodium diet while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I should not crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. This gradual reduction helps minimize potential withdrawal symptoms and ensures a safer discontinuation process. Choices A, B, and D are incorrect because taking escitalopram on an empty stomach, following a low-sodium diet, and not crushing the medication are not directly related to the safe and effective use of the medication or its discontinuation process.

4. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

5. A healthcare professional is preparing to administer IV Dantrolene to a client who has developed Malignant Hyperthermia during surgery. Which of the following actions should the healthcare professional take?

• A. Dilute the medication with sterile water and administer it rapidly.
• B. Store the medication in a refrigerator until use.
• C. Administer the medication through a large-bore IV catheter.
• D. Administer the medication via an infusion pump over 60 minutes.

Correct answer: C

Rationale: Dantrolene should be administered through a large-bore IV catheter because it is highly irritating to tissues and can cause vein irritation or thrombophlebitis if administered through a small vein. Using a large-bore IV catheter helps to minimize the risk of tissue damage and ensures proper and safe administration of the medication in emergency situations like Malignant Hyperthermia. Choices A, B, and D are incorrect because diluting the medication with sterile water and administering it rapidly can lead to tissue damage, storing the medication in a refrigerator is not necessary, and administering the medication via an infusion pump over 60 minutes is not appropriate in emergency situations like Malignant Hyperthermia where rapid administration is crucial.

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