Nursing Elites

1. A nurse preparing a client for surgery reviews the client's medication record. The client is to be nothing per mouth (NPO) after midnight. Which of the following medications, if noted on the client's record, should the nurse question?

• A. Cyclobenzaprine (Flexeril)
• B. Alendronate (Fosamax)
• C. Allopurinol (Zyloprim)
• D. Prednisone

Correct answer: D

Rationale: Prednisone is a corticosteroid that can cause adrenal atrophy, reducing the body's ability to withstand stress. During surgery, the dosage may need to be adjusted due to its impact on the body's stress response. Choices A, B, and C are not typically contraindicated before surgery and do not have the same potential impact on the body's stress response.

2. A client with diabetes mellitus is prescribed prednisone for an acute exacerbation of asthma. Which of the following should the nurse include in the client's teaching plan?

• A. Increase the dose of insulin while taking prednisone.
• B. Take the prednisone with food.
• C. Monitor blood glucose levels closely.
• D. Do not discontinue prednisone abruptly.

Correct answer: C

Rationale: The correct answer is to monitor blood glucose levels closely. Prednisone can elevate blood glucose levels, necessitating close monitoring. Adjusting the insulin dose may be necessary, but this should be managed by a healthcare provider. Prednisone should be taken with food to reduce gastrointestinal discomfort and should not be stopped suddenly to prevent adverse effects.

3. A client is prescribed phenytoin (Dilantin) for seizure control. Which statement by the client indicates an understanding of the medication?

• A. I should brush and floss my teeth regularly.
• B. I should take the medication with antacids.
• C. I can stop taking the medication once my seizures are controlled.
• D. I should avoid drinking milk while taking this medication.

Correct answer: A

Rationale: The correct statement is 'I should brush and floss my teeth regularly.' Phenytoin (Dilantin) can cause gingival hyperplasia, so maintaining good oral hygiene is essential. Taking the medication with antacids can affect its absorption, so it should not be done. It is crucial not to stop taking the medication abruptly, even if seizures are controlled. There is no specific requirement to avoid milk while taking phenytoin (Dilantin).

4. Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?

• A. Potassium level
• B. Creatinine level
• C. Cholesterol level
• D. Blood urea nitrogen

Correct answer: A

Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.

5. A client is prescribed metronidazole (Flagyl) for a trichomoniasis infection. Which of the following should the nurse include in the teaching plan?

• A. Avoid consuming alcohol while taking this medication.
• B. Take the medication with food.
• C. Increase fluid intake to prevent kidney stones.
• D. Report any gastrointestinal upset to the healthcare provider.

Correct answer: A

Rationale: The correct answer is A. Metronidazole (Flagyl) can cause a disulfiram-like reaction when taken with alcohol, resulting in severe nausea, vomiting, and headache. Therefore, the client should be advised to avoid alcohol while taking this medication to prevent adverse effects. Avoiding alcohol is crucial to prevent these reactions and ensure the effectiveness of the treatment. The other options are not directly related to the specific medication or the condition being treated.

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