Nursing Elites

1. Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which of the following food items?

• A. Milk
• B. Water
• C. Apple juice
• D. Orange juice

Correct answer: D

Rationale: Iron absorption is enhanced by the presence of vitamin C. Orange juice is a good source of vitamin C, which can improve the absorption of iron when taken together. Therefore, administering iron supplements with orange juice is the best choice to optimize iron absorption for the child.

2. A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache?

• A. Naproxen (Aleve)
• B. Ibuprofen (Advil)
• C. Acetaminophen (Tylenol)
• D. Acetylsalicylic acid (aspirin)

Correct answer: C

Rationale: Acetaminophen is the preferred choice for pain relief in individuals taking lansoprazole for Zollinger-Ellison syndrome due to its lower risk of stomach irritation compared to NSAIDs like ibuprofen and aspirin. Naproxen, ibuprofen, and aspirin are NSAIDs that can increase the risk of stomach irritation and bleeding, which is why they are not recommended for individuals with Zollinger-Ellison syndrome who are already on lansoprazole to reduce stomach acid production.

3. A client is receiving sulfisoxazole. Which of the following should be included in the list of instructions?

• A. Restrict fluid intake.
• B. Maintain a high fluid intake.
• C. If the urine turns dark brown, call the healthcare provider (HCP) immediately.
• D. Decrease the dosage when symptoms are improving to prevent an allergic response.

Correct answer: B

Rationale: When a client is taking sulfisoxazole, it is important to maintain a high fluid intake. Each dose of sulfisoxazole should be taken with a full glass of water, as the medication is more soluble in alkaline urine. Restricting fluid intake is not recommended as it can lead to inadequate hydration. Dark brown urine may be a side effect of some forms of sulfisoxazole but does not necessarily warrant immediate notification of the healthcare provider unless accompanied by other concerning symptoms. Decreasing the dosage when symptoms improve is not advised as it may lead to treatment failure or the development of resistance.

4. The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?

• A. Glucose level
• B. Calcium level
• C. Potassium level
• D. Prothrombin time

Correct answer: B

Rationale: The correct answer is B: Calcium level. Tamoxifen may increase calcium levels, leading to hypercalcemia. Symptoms of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, muscle weakness, and bone pain. Monitoring serum calcium levels is essential to detect and manage this potential side effect. Choices A, C, and D are incorrect because tamoxifen does not directly affect glucose, potassium, or prothrombin time levels significantly.

5. A healthcare professional prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The healthcare professional plans to include which of the following in the instructions?

• A. Instruct the client to drink 3000 mL of fluid per day.
• B. Instruct the client to take the medication with food.
• C. Inform the client that the effect of the medication will occur immediately.
• D. Instruct the client that, if swelling of the lips occurs, this is a normal expected response.

Correct answer: A

Rationale: Allopurinol is an antigout medication that works by reducing the production of uric acid in the body. To prevent kidney stones and promote the excretion of uric acid, increased fluid intake is essential. Instructing the client to drink 3000 mL of fluid per day helps to reduce the risk of kidney stones and assists in the elimination of uric acid, thereby enhancing the effectiveness of allopurinol therapy.

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