Nursing Elites

1. A client with a history of coronary artery disease (CAD) is being discharged with a prescription for aspirin. Which instruction should the nurse reinforce with the client?

• A. Take the aspirin on an empty stomach for better absorption.
• B. Stop taking the aspirin if you experience any stomach discomfort.
• C. Take the aspirin with food to reduce the risk of stomach irritation.
• D. Take the aspirin only when you have chest pain.

Correct answer: C

Rationale: The correct instruction is to take the aspirin with food to reduce the risk of stomach irritation. This is crucial for clients with a history of coronary artery disease as it helps minimize gastrointestinal side effects like irritation and bleeding. Option A is incorrect because aspirin should not be taken on an empty stomach to prevent stomach upset. Option B is incorrect because discontinuing aspirin at the first sign of stomach discomfort can be harmful, and a healthcare provider should be consulted instead. Option D is incorrect because aspirin is often prescribed for prevention in cardiovascular conditions, not just for chest pain relief.

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

• A. Take the medication with food.
• B. Monitor for signs of hypoglycemia.
• C. Increase fluid intake.
• D. Expect a metallic taste in the mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration can also help reduce the risk of kidney problems associated with metformin use. Choices A, B, and D are incorrect. While it's generally recommended to take metformin with food to reduce stomach upset, monitoring for signs of hypoglycemia is more relevant for other antidiabetic medications, and a metallic taste in the mouth is not a common side effect of metformin.

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

• A. Take the medication with a full glass of water.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication at bedtime.
• D. Avoid dairy products while taking the medication.

Correct answer: A

Rationale: When taking alendronate, it is important to take the medication with a full glass of water to prevent esophageal irritation. This helps ensure that the medication reaches the stomach and is properly absorbed. Lying down after taking alendronate can increase the risk of esophageal irritation, which is why it is recommended to stay upright for at least 30 minutes after taking the medication. Taking the medication at bedtime or avoiding dairy products are not specific instructions associated with alendronate administration. Therefore, the correct instruction to include is to take the medication with a full glass of water.

4. The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?

• A. Swallow the tablet whole with water.
• B. Place the tablet under the tongue and let it dissolve.
• C. Chew the tablet and then swallow.
• D. Place the tablet between the cheek and gum.

Correct answer: B

Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.

5. The nurse is teaching a client with coronary artery disease (CAD) about the risk factors for the disease. Which modifiable risk factor should the nurse emphasize?

• A. Family history
• B. Age
• C. Cigarette smoking
• D. Gender

Correct answer: C

Rationale: Cigarette smoking is a modifiable risk factor for coronary artery disease (CAD) as it can be changed or controlled to reduce the risk of developing CAD. Family history, age, and gender are non-modifiable risk factors that cannot be changed. Emphasizing the importance of quitting smoking can help the client reduce their risk of CAD and improve their overall cardiovascular health. Therefore, the correct answer is C. Choice A (Family history), B (Age), and D (Gender) are non-modifiable risk factors and not the focus of modifiable risk reduction strategies in CAD prevention.

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