Nursing Elites

1. A client with chronic kidney disease has a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

• A. Iron
• B. Protein
• C. Potassium
• D. Sodium

Correct answer: A

Rationale: Patients with chronic kidney disease are often prescribed epoetin alfa to treat anemia. Epoetin alfa stimulates red blood cell production, increasing the body's demand for iron to support this process. Therefore, clients taking epoetin alfa should be advised to increase their dietary intake of iron-rich foods to meet the increased demand and prevent iron deficiency anemia. Choices B, C, and D are incorrect because while protein is essential for overall health, potassium and sodium intake may need to be restricted in clients with chronic kidney disease to manage electrolyte balance and blood pressure.

2. What is the therapeutic use of Alprazolam?

• A. Preventing thrombus formation
• B. Relief of anxiety
• C. Decreasing the risk of stroke
• D. Increasing urinary output

Correct answer: B

Rationale: The therapeutic use of Alprazolam is for the relief of anxiety. Alprazolam belongs to a class of medications known as benzodiazepines, which are commonly prescribed to manage anxiety disorders and panic attacks. It works by enhancing the effects of a natural chemical in the body (GABA) to produce a calming effect on the brain and nerves, thereby alleviating symptoms of anxiety.

3. 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.

4. When educating a client with a new prescription for albuterol, which instruction should the nurse include?

• A. Use the inhaler every 4 hours.
• B. Shake the inhaler before use.
• C. Take a deep breath before inhaling the medication.
• D. Use a spacer when using the inhaler.

Correct answer: B

Rationale: Shaking the albuterol inhaler before use is essential to ensure that the medication is evenly mixed and properly delivered when inhaled. This maximizes the effectiveness of the medication in opening the airways and relieving symptoms of bronchospasm.

5. A healthcare provider is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare provider plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 minutes.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hours of manifestation onset.

Correct answer: B

Rationale: When administering IV Alteplase for a massive Pulmonary Embolism, the healthcare provider should plan to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This is crucial to prevent bleeding complications at the puncture sites. Choice A is incorrect because Enoxaparin is not usually administered along with Alteplase for a Pulmonary Embolism. Choice C is incorrect because Aminocaproic acid is not typically given prior to alteplase infusion in this situation. Choice D is incorrect because Alteplase should be administered within 2 hours of onset of manifestations for Pulmonary Embolism, not within 8 hours.

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