Nursing Elites

1. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: When taking colesevelam, it should be administered with food and at least 8 oz of water to ensure proper absorption and reduce the risk of gastrointestinal side effects. Taking colesevelam with food also helps in binding to bile acids efficiently. Options A, B, and C are incorrect because they do not provide the necessary instruction for taking colesevelam correctly or monitoring specific side effects associated with this medication.

2. A healthcare provider is caring for a client who is prescribed Furosemide. Which of the following laboratory values should the healthcare provider monitor?

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

Correct answer: A

Rationale: Furosemide is a loop diuretic that can cause hypokalemia (low potassium levels) due to increased potassium excretion in the urine. Monitoring serum potassium levels is crucial to prevent complications such as cardiac arrhythmias. Therefore, the healthcare provider should closely monitor the client's serum potassium levels when they are prescribed Furosemide. While monitoring other electrolytes like sodium and magnesium may also be important in certain situations, the priority for a client prescribed Furosemide is to monitor serum potassium levels due to the risk of hypokalemia.

3. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

4. A client has a new prescription for Oxycodone/Acetaminophen. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking additional Acetaminophen while on Oxycodone/Acetaminophen. This is important to prevent exceeding the maximum recommended dose and reducing the risk of liver toxicity. Oxycodone/Acetaminophen already contains Acetaminophen, so additional intake can lead to an overdose of this component. Choices A, C, and D are incorrect. Taking the medication on an empty stomach or increasing fiber intake are not specific instructions related to this medication. Avoiding taking the medication before bedtime is not directly relevant to the combination of Oxycodone/Acetaminophen.

5. A client has a new prescription for Atenolol. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B. Atenolol is a beta-blocker that can cause bradycardia, leading to a decreased heart rate. Monitoring heart rate regularly is essential to detect any significant decreases promptly and seek medical attention. While choices A, C, and D may be relevant to the client's overall health, monitoring heart rate is the priority instruction due to the nature of Atenolol's effects. Taking the medication in the morning can be individualized based on the client's needs and preferences. Avoiding foods high in potassium and increasing fluid intake are generally beneficial but not directly related to managing the side effects of Atenolol.

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