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. When administering Phenytoin, what should you monitor?

• A. Behavior
• B. Therapeutic blood levels
• C. For signs of Stevens-Johnson syndrome
• D. All of the above

Correct answer: D

Rationale: When administering Phenytoin, monitoring the patient's behavior is important to assess for any changes that may indicate adverse effects. Monitoring therapeutic blood levels helps ensure the medication is within the effective range and not causing toxicity. Additionally, being vigilant for signs of Stevens-Johnson syndrome, a severe skin reaction associated with Phenytoin use, is crucial for early detection and intervention. Therefore, monitoring behavior, therapeutic blood levels, and for signs of Stevens-Johnson syndrome are all essential when administering Phenytoin.

3. A nurse is providing teaching to a client who has a new prescription for Metoprolol. Which of the following statements should the nurse include?

• A. This medication may make you feel dizzy at first.
• B. You should avoid foods that are high in fat.
• C. Take the medication in the morning.
• D. You may experience a rapid heart rate while taking this medication.

Correct answer: A

Rationale: Metoprolol, a beta-blocker, can cause dizziness, especially when starting the medication. The nurse should inform the client to change positions slowly to avoid dizziness and falls.

4. What is one of the therapeutic uses of Valproate?

• A. Suppression of seizure activity
• B. Replacement of hypothyroidism to restore normal hormone balance
• C. Maintenance of blood glucose
• D. Lowering of blood pressure

Correct answer: A

Rationale: Valproate, also known as Valproic acid, is commonly used in medicine for the suppression of seizure activity. It is an anticonvulsant medication that helps manage and prevent seizures in various conditions such as epilepsy. While it is not used for replacing hypothyroidism, maintaining blood glucose levels, or lowering blood pressure, its primary therapeutic use is in managing seizures.

5. A healthcare professional is caring for a client who has a new prescription for Lisinopril. Which of the following laboratory values should the professional monitor?

• A. Serum potassium
• B. Serum sodium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing the excretion of potassium in the kidneys. Monitoring serum potassium levels is essential to prevent complications such as cardiac arrhythmias. Therefore, the healthcare professional should closely monitor the client's serum potassium levels when they are on Lisinopril. Choices B, C, and D are incorrect because Lisinopril primarily affects potassium levels due to its mechanism of action as an ACE inhibitor. Serum sodium, calcium, and magnesium levels are not typically affected by Lisinopril in the same way as potassium.

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