A nurse is giving medicinal instructions to a female client receiving leflunomide (Arava). Which of the following is an appropriate instruction with the use of the medication?

Correct Answer: A

Rationale: Leflunomide is teratogenic and can cause severe birth defects. Women of childbearing age must use effective contraception during treatment and for a period after discontinuation. Breastfeeding is contraindicated due to the risk of harm to the infant. Cholestyramine is used to accelerate the elimination of leflunomide in case of toxicity, not to lessen side effects. Improvement in symptoms typically takes weeks, not days.

Correct Answer: C

Rationale: To prescribe 250mg of K penicillin V, you would need to have 10ml of the liquid preparation (125mg/5ml x 10ml = 250mg). Since 1 teaspoon (tsp) is approximately equal to 5ml, you would need to prescribe 2 teaspoons of the liquid preparation for the patient to take 250mg per dose.

Correct Answer: A

Rationale: Enteral nutrition involves delivering nutrients directly into the gastrointestinal tract, typically via a tube, and can be administered intermittently (e.g., bolus feedings) or continuously (e.g., via a pump), offering flexibility based on the client's needs and tolerance. This method contrasts with parenteral nutrition, which uses veins, making the venous administration statement inaccurate for enteral feeding. The purpose of enteral nutrition often includes supporting clients who cannot swallow adequately-due to conditions like dysphagia-ensuring they receive sufficient calories and nutrients to prevent malnutrition. However, enteral feedings are typically formula-based, not thinned pureed food, as specialized formulas provide balanced nutrition tailored to medical needs, unlike pureed diets which are less common in tube feeding. The intermittent or continuous delivery option is key education, as it addresses how the therapy adapts to lifestyle and clinical status, providing practical understanding for the client and family while clarifying enteral nutrition's gastrointestinal focus over intravenous methods.

Correct Answer: A

Rationale: One of the key differences between Angiotensin II Receptor Blockers (ARBs) and Angiotensin-Converting Enzyme (ACE) inhibitors is their impact on potassium levels. While both medications can cause hyperkalemia (high potassium levels), it is generally considered more likely to occur with ARBs compared to ACE inhibitors. This is because ACE inhibitors inhibit the breakdown of bradykinin, which in turn can enhance potassium retention, increasing the risk of hyperkalemia. Therefore, the nurse would correctly identify this statement about ARBs as being true.

Correct Answer: C

Rationale: Teriflunomide, used in multiple sclerosis, inhibits dihydroorotate dehydrogenase, blocking pyrimidine synthesis critical for lymphocyte proliferation, reducing CNS inflammation by limiting activated immune cells. Riluzole modulates glutamate for ALS, not immunity. Rotigotine, a dopamine agonist, treats Parkinson's. Dexamethasone, a corticosteroid, suppresses inflammation broadly via glucocorticoid pathways, not pyrimidine-specific mechanisms. Teriflunomide's targeted action on lymphocyte replication distinguishes it in MS, decreasing relapses by curbing immune-mediated damage, a precise fit for this description.