Nursing Elites

1. When educating a client with a new prescription for Amlodipine, which instruction should the nurse provide?

• A. Increase your intake of dairy products.
• B. Avoid driving until you see how the medication affects you.
• C. Stop taking the medication if you develop a dry cough.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid driving until they understand the medication's effects. Amlodipine can cause dizziness, making it unsafe to drive until the client knows how the medication affects them. This instruction promotes client safety and prevents potential accidents due to medication side effects.

2. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• A. This medication can safely be taken during pregnancy.
• B. Eliminate grapefruit juice from your diet.
• C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
• D. Notify your provider if you develop a rash.

Correct answer: B

Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.

3. A client has been prescribed Nitroglycerin patches for angina. Which of the following instructions should the nurse include during discharge teaching?

• A. Apply the patch to a different site each time.
• B. Remove the patch for 12 hours each day.
• C. Apply the patch at the same time every day.
• D. Cut the patch in half if your blood pressure is well controlled.

Correct answer: B

Rationale: The correct answer is B: 'Remove the patch for 12 hours each day.' Nitroglycerin patches should be removed for 12 hours each day to prevent the development of tolerance. This nitrate-free interval ensures the medication remains effective in managing angina. Choice A is incorrect because applying the patch to a different site each time is not necessary; it is more important to ensure a nitrate-free interval. Choice C is incorrect because while consistency in timing is good for medication adherence, the crucial aspect for Nitroglycerin patches is the nitrate-free interval. Choice D is incorrect because cutting the patch in half based on blood pressure control is not a recommended practice and could alter the medication's efficacy.

4. In the management of nausea due to gastroparesis in a client with Diabetes, which of the following medications may be prescribed?

• A. Lubiprostone
• B. Metoclopramide
• C. Bisacodyl
• D. Loperamide

Correct answer: B

Rationale: Metoclopramide, as a dopamine antagonist, is commonly prescribed to manage nausea and improve gastric motility in clients with diabetic gastroparesis. By enhancing gastric emptying, it can help alleviate symptoms like bloating and nausea associated with gastroparesis. Choice A, Lubiprostone, is primarily used to treat chronic idiopathic constipation and irritable bowel syndrome with constipation, not nausea due to gastroparesis. Choice C, Bisacodyl, is a stimulant laxative used for the treatment of constipation and bowel preparation before procedures, not for nausea associated with gastroparesis. Choice D, Loperamide, is an antimotility agent used to manage diarrhea, not nausea or gastric motility issues seen in gastroparesis.

5. When educating a client who has a prescription for Propranolol, what instruction should the healthcare provider include?

• A. Take this medication with food.
• B. Discontinue the medication if you feel fatigued.
• C. Expect to have decreased heart rate with this medication.
• D. Do not stop taking this medication abruptly.

Correct answer: D

Rationale: The correct instruction for a client with a prescription for Propranolol is not to stop taking the medication abruptly. Abrupt cessation can result in rebound hypertension or other cardiac complications. It is crucial for the client to taper off the medication gradually under healthcare provider supervision to prevent adverse effects. Choice A is incorrect because Propranolol can be taken with or without food. Choice B is incorrect as discontinuing the medication based on fatigue alone is not advisable without consulting a healthcare provider. Choice C is incorrect because while Propranolol can decrease heart rate, it is not the primary instruction to provide in this scenario.

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