Nursing Elites

1. Prior to administering an oral dose of methylprednisolone, what is most important for the nurse to do?

• A. Administer the medication with a glass of milk
• B. Notify the healthcare provider of the finding
• C. Begin tapering the drug dose per protocol
• D. Teach the clients about foods high in calcium

Correct answer: A

Rationale: Administering methylprednisolone with food or milk is important as it can help reduce gastrointestinal side effects associated with the medication. This practice is commonly recommended to minimize stomach upset and irritation that may occur when taking methylprednisolone on an empty stomach. Therefore, it is crucial for the nurse to provide the medication with a glass of milk to enhance patient comfort and adherence to the treatment regimen. Choice B is incorrect as there is no indication in the question stem that suggests a need to notify the healthcare provider before administering the medication with food or milk. Choice C is incorrect because tapering the drug dose per protocol is not the immediate action needed prior to administering the first dose of methylprednisolone. Choice D is irrelevant to the administration of methylprednisolone and not the most important action to take before giving the medication.

2. A client with chronic kidney disease is prescribed ferric citrate. The nurse should monitor for which potential side effect?

• A. Constipation
• B. Diarrhea
• C. Nausea
• D. Hyperphosphatemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate. Diarrhea, nausea, and hyperphosphatemia are not typically associated with the use of ferric citrate in clients with chronic kidney disease.

3. A client with chronic obstructive pulmonary disease (COPD) is prescribed albuterol. The nurse should monitor for which potential side effect?

• A. Tachycardia
• B. Nausea
• C. Dry mouth
• D. Weight gain

Correct answer: A

Rationale: Correct Answer: A. Albuterol, a bronchodilator commonly used in COPD, can cause tachycardia as a potential side effect due to its beta-agonist properties that can stimulate the heart. Nausea (Choice B), dry mouth (Choice C), and weight gain (Choice D) are less likely associated with albuterol use. Nausea and dry mouth are not common side effects of albuterol, and weight gain is not typically linked to its use. Therefore, the nurse should primarily monitor for tachycardia when a client is prescribed albuterol for COPD.

4. A 67-year-old client is discharged from the hospital with a prescription for digoxin 0.25 mg daily. Which instruction by the practical nurse (PN) is correct?

• A. Take the medication in the morning before getting out of bed.
• B. Do not take the medication if the heartbeat is irregular or slow.
• C. Expect some vision changes due to the medication.
• D. Increase intake of foods rich in potassium.

Correct answer: B

Rationale: The correct instruction for a client taking digoxin is not to take the medication if the heartbeat is irregular or slow. Digoxin can affect the heart rhythm, so it is crucial to monitor the pulse rate. In case of irregular or slow heartbeats, the medication should be withheld, and the healthcare provider should be consulted. This step is necessary to prevent potential complications associated with digoxin therapy. Choices A, C, and D are incorrect. Taking digoxin in the morning before getting out of bed is not a specific requirement. Vision changes are not a common side effect of digoxin. While digoxin can affect potassium levels, it is not advised to increase potassium intake without healthcare provider guidance.

5. What instructions should the PN reinforce with the client regarding the newly prescribed medications isosorbide dinitrate and hydrochlorothiazide?

• A. Instruct the client to use a soft bristle toothbrush.
• B. Instruct the client to slowly rise from a sitting or lying down position.
• C. Instruct the client to elevate their legs above the level of their heart.
• D. Instruct the client to limit the amount of fiber in their diet.

Correct answer: B

Rationale: The correct instruction for the client is to slowly rise from a sitting or lying down position. Isosorbide dinitrate, a nitrate, and hydrochlorothiazide, a diuretic, can both cause hypotension. When used together, their additive effects can further lower blood pressure, leading to orthostatic hypotension. Instructing the client to change positions slowly helps prevent a sudden drop in blood pressure, reducing the risk of dizziness or falls. Choices A, C, and D are incorrect because they do not directly address the potential side effect of hypotension associated with the prescribed medications. Using a soft bristle toothbrush, elevating legs above the heart level, or limiting fiber intake are not specific instructions to mitigate the risk of orthostatic hypotension.

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