Nursing Elites

1. A client with hypertension is prescribed losartan (Cozaar). Which instruction should the nurse include in the teaching plan?

• A. Avoid foods high in potassium.
• B. Take the medication with grapefruit juice.
• C. Monitor blood pressure weekly.
• D. Report any swelling of the lips or face.

Correct answer: D

Rationale: The correct instruction for a client prescribed losartan (Cozaar) is to report any swelling of the lips or face. Losartan can cause angioedema, which is a serious side effect that requires immediate medical attention. Clients do not need to avoid potassium-rich foods unless specifically instructed by their healthcare provider. Taking the medication with grapefruit juice is not recommended as it can interact with certain medications. Additionally, monitoring blood pressure regularly is important, but it should not be limited to a weekly basis; blood pressure should be monitored as per the healthcare provider's recommendation.

2. A client is taking levothyroxine (Synthroid) for hypothyroidism. Which symptom would indicate to the nurse that the client is taking too much medication?

• A. Bradycardia
• B. Lethargy
• C. Tremors
• D. Constipation

Correct answer: C

Rationale: When a client is taking an excessive dose of levothyroxine (Synthroid), it can lead to symptoms of hyperthyroidism. Tremors are a common sign of excessive medication, along with tachycardia and insomnia. Bradycardia, lethargy, and constipation are typical symptoms of hypothyroidism, indicating that the client may require a higher dose of levothyroxine rather than too much.

3. A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?

• A. Apply the patch to a hairless area of skin.
• B. Leave the patch on for 24 hours.
• C. Apply the patch at the same time each day.
• D. You can keep the patch on while taking a shower.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching plan is to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day. This consistency helps maintain steady blood levels of the medication. While it is important to apply the patch to a hairless area of the skin for proper absorption, it does not necessarily have to be left on for 24 hours; typically, it is worn for 12-14 hours to allow for a nitrate-free period and reduce tolerance. Additionally, the patch can generally be kept on while taking a shower, as water exposure does not typically affect its efficacy.

4. A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?

• A. I need to watch for signs of infection.
• B. I need to discontinue the medication after 14 days of use.
• C. I can take the medication with meals to minimize nausea.
• D. I need to call the health care provider (HCP) if more than one dose is missed.

Correct answer: B

Rationale: Azathioprine is an immunosuppressant taken for life. Discontinuing the medication after 14 days is incorrect.

5. A nurse is monitoring a client receiving lithium carbonate for bipolar disorder. Which finding should the nurse report immediately to the healthcare provider?

• A. Increased thirst
• B. Fine hand tremors
• C. Frequent urination
• D. Persistent vomiting

Correct answer: D

Rationale: Persistent vomiting can be a sign of lithium toxicity, which requires immediate medical attention. Increased thirst, fine hand tremors, and frequent urination are common side effects of lithium.

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