Nursing Elites

1. The healthcare provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatment?

• A. The medication is an antibacterial.
• B. The medication will help heal the burn.
• C. The medication will permanently stain my skin.
• D. The medication should be applied directly to the wound.

Correct answer: C

Rationale: The correct answer is C. Silver sulfadiazine is an antibacterial used to treat burns, helping in the healing process. It does not permanently stain the skin. Therefore, the statement indicating a lack of understanding is that the medication will permanently stain the skin.

2. A client receiving nitrofurantoin (Macrodantin) calls the health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?

• A. Nausea
• B. Diarrhea
• C. Anorexia
• D. Cough and chest pain

Correct answer: D

Rationale: Pulmonary reactions such as cough and chest pain are serious side effects associated with nitrofurantoin that require immediate discontinuation of the medication to prevent potential severe respiratory complications.

3. A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?

• A. I will take my pills every day at the same time.
• B. I will be certain to avoid alcohol consumption.
• C. I have already called my family to pick up a Medic-Alert bracelet.
• D. I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.

Correct answer: D

Rationale: Ecotrin is an aspirin-containing product and should be avoided. Clients should avoid alcohol consumption, take prescribed medication at the same time each day, and use a Medic-Alert bracelet for emergency information.

4. A client with hypertension is prescribed lisinopril (Zestril). Which instruction should the nurse include in the teaching plan?

• A. Avoid foods high in potassium.
• B. Avoid taking the medication with grapefruit juice.
• C. Monitor blood pressure regularly.
• D. Report any swelling of the lips or face.

Correct answer: D

Rationale: The correct instruction for the nurse to include in the teaching plan is to 'Report any swelling of the lips or face.' Lisinopril (Zestril) can cause angioedema, which is swelling of the lips or face. This is a serious side effect that should be reported immediately. Clients do not need to avoid potassium-rich foods unless instructed by their healthcare provider, should avoid taking the medication with grapefruit juice, and should monitor their blood pressure regularly, not just weekly.

5. A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which of the following indicates toxicity associated with the medication?

• A. Sodium of 140 mEq/L
• B. Prothrombin time of 12 seconds
• C. Platelet count of 400,000 cells/mm³
• D. A direct bilirubin level of 2 mg/dL

Correct answer: D

Rationale: A direct bilirubin level of 2 mg/dL indicates liver damage, which can be caused by an overdose of acetaminophen. Acetaminophen toxicity can lead to liver injury, manifesting as elevated bilirubin levels and other liver function test abnormalities.

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