Nursing Elites

1. When administering Phenytoin, what should you monitor?

• A. Behavior
• B. Therapeutic blood levels
• C. For signs of Stevens-Johnson syndrome
• D. All of the above

Correct answer: D

Rationale: When administering Phenytoin, monitoring the patient's behavior is important to assess for any changes that may indicate adverse effects. Monitoring therapeutic blood levels helps ensure the medication is within the effective range and not causing toxicity. Additionally, being vigilant for signs of Stevens-Johnson syndrome, a severe skin reaction associated with Phenytoin use, is crucial for early detection and intervention. Therefore, monitoring behavior, therapeutic blood levels, and for signs of Stevens-Johnson syndrome are all essential when administering Phenytoin.

2. Which of the following is the primary site of activity for the drug Warfarin?

• A. Kidney
• B. Liver
• C. Blood
• D. Heart

Correct answer: B

Rationale: Warfarin primarily affects the liver where it inhibits the synthesis of clotting factors.

3. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?

• A. Metformin
• B. Metoprolol
• C. Lisinopril
• D. Insulin

Correct answer: A

Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.

4. A client with peptic ulcer disease is prescribed sucralfate. Which of the following instructions should the nurse include?

• A. Take sucralfate with meals.
• B. Take sucralfate 1 hr before meals.
• C. Take sucralfate with antacids.
• D. Take sucralfate 2 hours after meals.

Correct answer: B

Rationale: The correct instruction for taking sucralfate is 1 hour before meals. This timing allows sucralfate to effectively coat the stomach lining and provide a protective barrier against gastric acid, helping to prevent ulcers.

5. When educating a client who has a new prescription for Levothyroxine to treat hypothyroidism, which of the following instructions should be included?

• A. Take the medication first thing in the morning before eating.
• B. Take the medication at bedtime to avoid drowsiness.
• C. Take the medication with food to prevent nausea.
• D. Take the medication with a glass of milk.

Correct answer: A

Rationale: Levothyroxine should be taken first thing in the morning before eating to ensure optimal absorption. Taking it on an empty stomach helps prevent interactions with food or other medications that may decrease its effectiveness. It is important to follow this timing recommendation to maintain consistent thyroid hormone levels in the body. Choice B is incorrect as taking Levothyroxine at bedtime may lead to inconsistent absorption and affect its efficacy. Choice C is incorrect because taking Levothyroxine with food can interfere with its absorption. Choice D is incorrect as Levothyroxine should be taken with a full glass of water, not milk, to aid in proper absorption.

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