Nursing Elites

1. The client has reinforced instructions for taking cholestyramine (Questran). Which statement indicates a need for further instructions?

• A. I will continue taking vitamin supplements.
• B. This medication will help lower my cholesterol.
• C. This medication should only be taken with water.
• D. A high-fiber diet is important while taking this medication.

Correct answer: C

Rationale: The correct answer is C because cholestyramine should not only be taken with water. Flavored products or fruit juices can improve the taste. Choices A, B, and D are all correct statements. It is important for the client to continue taking vitamin supplements, understand that cholestyramine helps lower cholesterol, and maintain a high-fiber diet while taking this medication to enhance its effectiveness.

2. When administering hydrochlorothiazide (HydroDIURIL) to a client, the nurse should be aware of which of the following concerns?

• A. Hypouricemia, hyperkalemia
• B. Increased risk of osteoporosis
• C. Hypokalemia, hyperglycemia, sulfa allergy
• D. Hyperkalemia, hypoglycemia, penicillin allergy

Correct answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a thiazide diuretic, which can lead to hypokalemia and hyperglycemia. It is also associated with hypercalcemia, hyperlipidemia, and hyperuricemia. Being a sulfa-based medication, individuals with a sulfa allergy are at risk for an allergic reaction when taking hydrochlorothiazide. Choice A is incorrect because hydrochlorothiazide can cause hyperkalemia rather than hypouricemia. Choice B is incorrect as there is no direct link between hydrochlorothiazide and an increased risk of osteoporosis. Choice D is incorrect because hypoglycemia and penicillin allergy are not typically associated with hydrochlorothiazide use.

3. The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

• A. Diarrhea
• B. Heartburn
• C. Flatulence
• D. Constipation

Correct answer: B

Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.

4. Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client-teaching plan regarding this medication?

• A. To take the medication after meals
• B. To return to the clinic weekly for serum drug-level testing
• C. To call the health care provider (HCP) if a skin rash occurs
• D. To restrict alcohol intake with this medication

Correct answer: B

Rationale: Cycloserine requires weekly serum drug level determinations to monitor for neurotoxicity. The medication must be taken after meals, and the client should avoid alcohol. Additionally, the client should report any signs of skin rash or central nervous system toxicity to the healthcare provider.

5. Which laboratory test should the nurse monitor to determine the effectiveness of heparin therapy for a client with deep vein thrombosis?

• A. Platelet count
• B. Prothrombin time (PT)
• C. Activated partial thromboplastin time (aPTT)
• D. Hemoglobin and hematocrit

Correct answer: C

Rationale: The activated partial thromboplastin time (aPTT) is the specific laboratory test used to monitor the effectiveness of heparin therapy in patients with deep vein thrombosis. It measures the time it takes for blood to clot and is crucial in assessing the therapeutic range of heparin. Platelet count, prothrombin time (PT), and hemoglobin and hematocrit levels are important parameters in assessing coagulation and blood status but do not directly indicate the effectiveness of heparin therapy.

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