Nursing Elites

1. A client is taking Sucralfate PO for Peptic Ulcer Disease and has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

• A. Take an antacid with the sucralfate.
• B. Take sucralfate with a glass of milk.
• C. Allow a 2-hour interval between these medications.
• D. Chew the sucralfate thoroughly before swallowing.

Correct answer: C

Rationale: Sucralfate can interfere with the absorption of phenytoin. To prevent this interaction, the client should allow a 2-hour interval between taking sucralfate and phenytoin. This timing helps to ensure adequate absorption and effectiveness of both medications without compromising therapeutic outcomes. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, and chewing sucralfate thoroughly before swallowing do not address the need for a 2-hour interval between these medications to prevent interference with phenytoin absorption.

2. A client with a prescription for Vasopressin to treat Diabetes Insipidus is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?

• A. I will reduce my sodium intake.
• B. I should increase my water intake.
• C. I will notify my doctor if I develop chest pain.
• D. I should take this medication with food.

Correct answer: C

Rationale: The correct answer is C because Vasopressin can cause vasoconstriction, potentially leading to chest pain. It is crucial for the client to inform their healthcare provider immediately if they experience chest pain while on Vasopressin therapy to address any potential cardiovascular complications promptly. Choices A, B, and D are incorrect. While maintaining adequate hydration is essential with Vasopressin therapy due to its antidiuretic effect, increasing water intake is not the most critical aspect to monitor. Reducing sodium intake may be beneficial in some cases but is not directly related to the potential side effects of Vasopressin. Taking the medication with food is not a specific instruction for Vasopressin administration.

3. A client is admitted for a surgical procedure. Which preexisting condition can be a contraindication for the use of Ketamine as an intravenous anesthetic?

• A. Peptic ulcer disease
• B. Breast cancer
• C. Diabetes mellitus
• D. Schizophrenia

Correct answer: D

Rationale: Ketamine can produce psychological effects like hallucinations. Patients with schizophrenia may be more prone to experiencing exacerbation of their symptoms when exposed to Ketamine due to its potential to worsen psychotic symptoms. Therefore, schizophrenia can be a contraindication for the use of Ketamine as an anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for the use of Ketamine.

4. A client is starting therapy with docetaxel. Which of the following findings should the nurse instruct the client to report?

• A. Flushing
• B. Dyspnea
• C. Hyperglycemia
• D. Tinnitus

Correct answer: B

Rationale: The correct answer is B: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a serious adverse effect of docetaxel. Dyspnea may be a sign of a potentially life-threatening condition that the healthcare provider needs to address promptly. Flushing (Choice A) is not typically associated with docetaxel therapy. Hyperglycemia (Choice C) is also not a common side effect of docetaxel. Tinnitus (Choice D) is not a usual finding with docetaxel and is not a priority over potential pulmonary toxicity indicated by dyspnea.

5. A client is prescribed Propylthiouracil (PTU) for the treatment of Graves' disease. Which adverse effect should the client be instructed to report?

• A. Sore throat.
• B. Drowsiness.
• C. Urinary retention.
• D. Heat intolerance.

Correct answer: A

Rationale: The correct answer is A: Sore throat. A sore throat and fever can indicate agranulocytosis, a serious adverse effect of PTU that can lead to a decreased white blood cell count. This condition requires immediate medical attention to prevent complications. Choice B, drowsiness, is not typically associated with PTU and is not a common adverse effect that needs to be reported. Choice C, urinary retention, is not a typical adverse effect of PTU; therefore, it is not the correct answer. Choice D, heat intolerance, is a symptom commonly seen in hyperthyroidism, which PTU is used to treat, so it is not an adverse effect that needs to be specifically reported.

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