Nursing Elites

1. Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?

• A. Neuralgia
• B. Insomnia
• C. Use of nitroglycerin
• D. Use of multivitamins

Correct answer: C

Rationale: The correct answer is C. Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide and is contraindicated with the concurrent use of organic nitrates and nitroglycerin. Using nitroglycerin together with Viagra can lead to severe hypotension and cardiovascular collapse, making it unsafe to combine both medications.

2. Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:

• A. 1 hour after each meal
• B. Once daily, at the same time each day
• C. 15 minutes before breakfast, lunch, and dinner
• D. Before each meal, based on the blood glucose level

Correct answer: B

Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.

3. A client is taking cetirizine hydrochloride (Zyrtec). The nurse checks for which of the following side effects of this medication?

• A. Diarrhea
• B. Excitability
• C. Drowsiness
• D. Excess salivation

Correct answer: C

Rationale: Cetirizine hydrochloride (Zyrtec) is known to commonly cause drowsiness or sedation as a side effect. Therefore, the nurse should monitor the client for signs of drowsiness when administering this medication. Choice A, Diarrhea, is not a common side effect of cetirizine. Choice B, Excitability, is not a typical side effect of this antihistamine; instead, it tends to cause drowsiness. Choice D, Excess salivation, is not associated with cetirizine use.

4. The healthcare provider is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The healthcare provider consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?

• A. Pancreatitis
• B. Diabetes mellitus
• C. Myocardial infarction
• D. Chronic obstructive pulmonary disease

Correct answer: A

Rationale: Asparaginase is contraindicated in clients with a history of pancreatitis due to the risk of impairing pancreatic function and causing complications. Therefore, the healthcare provider should consult with the registered nurse to assess the client's history of pancreatitis before administering asparaginase.

5. A healthcare provider has written a prescription for ranitidine (Zantac), once daily. When should the nurse schedule the medication?

• A. At bedtime
• B. After lunch
• C. With supper
• D. Before breakfast

Correct answer: A

Rationale: The correct answer is A: At bedtime. Ranitidine should be scheduled at bedtime because it provides a prolonged effect and offers the greatest protection of the gastric mucosa. Administering it at this time helps in managing nocturnal acid breakthrough and providing relief during the night.

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