Nursing Elites

1. 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.

2. A client has a new prescription for Captopril. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Increase your intake of sodium-rich foods.

Correct answer: C

Rationale: Captopril should be taken on an empty stomach for better absorption. The client should be instructed to take it 1 hour before or 2 hours after meals to optimize its effectiveness. Taking it with food can reduce its absorption and efficacy.

3. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.

4. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.

5. A healthcare professional is educating a client who has a new prescription for Vitamin B12 injections. Which of the following statements should the healthcare professional include?

• A. Take the medication with a full glass of water.
• B. You will need to take this medication for the rest of your life.
• C. Expect a metallic taste in your mouth.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is B: 'You will need to take this medication for the rest of your life.' Clients with conditions like pernicious anemia or other causes of vitamin B12 deficiency may require lifelong cyanocobalamin supplementation to prevent deficiency. This is because their bodies are unable to absorb B12 from dietary sources adequately, necessitating ongoing injections to maintain optimal B12 levels. Choices A, C, and D are incorrect. A full glass of water is not necessary for Vitamin B12 injections. Metallic taste in the mouth is not a common side effect of Vitamin B12 injections, and there is no need to avoid consuming dairy products specifically in relation to Vitamin B12 injections.

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