Nursing Elites

1. A client starting highly active antiretroviral therapy (HAART) for HIV infection is being educated by a nurse on preventing medication resistance. What information should the nurse provide the client about resistance?

• A. Taking low dosages of antiretroviral medication minimizes resistance.
• B. Taking one antiretroviral medication at a time minimizes resistance.
• C. Taking medication at the same time daily without missing doses minimizes resistance.
• D. Changing the medication regimen when adverse effects occur minimizes resistance.

Correct answer: C

Rationale: To prevent the development of medication resistance, it is crucial for the client to take antiretroviral medication consistently at the same time daily without missing doses. This practice helps maintain effective drug levels in the body, reducing the risk of resistance development.

2. A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

• A. Fomepizole
• B. Naloxone
• C. Phytonadione
• D. Diphenhydramine

Correct answer: D

Rationale: The client's symptoms of face spasms after receiving Prochlorperazine indicate acute dystonia, a known side effect. Diphenhydramine is commonly administered to manage extrapyramidal symptoms, such as muscle spasms, caused by medications like Prochlorperazine. Therefore, the nurse should anticipate a prescription for Diphenhydramine to alleviate the client's symptoms. Choices A, B, and C are incorrect because Fomepizole is used in methanol or ethylene glycol poisoning, Naloxone is an opioid antagonist used in opioid overdose, and Phytonadione is vitamin K, used to reverse the effects of certain blood thinners.

3. A healthcare professional is administering a Dopamine infusion at a low dose to a client with severe heart failure. Which of the following findings is an expected effect of this medication?

• A. Lowered heart rate
• B. Increased myocardial contractility
• C. Decreased conduction through the AV node
• D. Vasoconstriction of renal blood vessels

Correct answer: B

Rationale: Dopamine, when administered at a low dose, is expected to increase myocardial contractility by stimulating beta1 receptors. This positive inotropic effect leads to an increase in cardiac output. Therefore, the correct answer is increased myocardial contractility, as it is a desired effect of administering dopamine to a client with severe heart failure.

4. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication with food.
• B. I will monitor my blood sugar levels while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I can 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 dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.

5. A client with a new prescription for Verapamil to control hypertension is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I should avoid drinking grapefruit juice.
• B. I can expect my heart rate to increase while taking this medication.
• C. This medication will cause my urine to turn orange.
• D. I will stop taking this medication if I experience headaches.

Correct answer: A

Rationale: The correct answer is A. Grapefruit juice can increase blood levels of verapamil, leading to increased effects and potentially serious side effects such as hypotension or bradycardia. It is crucial for the client to avoid grapefruit juice while taking Verapamil to prevent these adverse reactions. Choice B is incorrect because verapamil is a calcium channel blocker that typically lowers heart rate. Choice C is incorrect as verapamil does not cause urine discoloration. Choice D is incorrect because stopping medication abruptly without consulting a healthcare provider can be dangerous.

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