Nursing Elites

1. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

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

• A. Monitor for signs of bleeding.
• B. Avoid taking the medication with food.
• C. Expect to have increased urination.
• D. Take the medication with an antacid.

Correct answer: A

Rationale: Corrected Rationale: Clopidogrel is an antiplatelet medication that increases the risk of bleeding. The client should monitor for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, and report them promptly to their healthcare provider for further evaluation and management. Choice B is incorrect because Clopidogrel can be taken with or without food. Choice C is incorrect as increased urination is not a common side effect of Clopidogrel. Choice D is incorrect as taking Clopidogrel with an antacid may reduce its effectiveness.

3. A client has a new prescription for Omeprazole. Which of the following statements should the nurse include in teaching the client?

• A. Take the medication before meals.
• B. You may experience a rapid heart rate.
• C. Increase your intake of high-calcium foods.
• D. Expect your urine to turn orange.

Correct answer: A

Rationale: The correct statement for the nurse to include when teaching a client prescribed Omeprazole is to take the medication before meals. Omeprazole, a proton pump inhibitor, is most effective when taken before meals as it works by reducing the amount of acid produced in the stomach. Choice B is incorrect because a rapid heart rate is not a common side effect of Omeprazole. Choice C is incorrect as there is no specific requirement to increase intake of high-calcium foods with Omeprazole. Choice D is also incorrect as Omeprazole does not typically cause urine discoloration.

4. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:

• A. Headaches
• B. Cold remedy
• C. Neuropathic pain
• D. Antianxiety

Correct answer: C

Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.

5. When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Avoid salt substitutes.
• B. Take this medication at bedtime.
• C. Increase your intake of potassium-rich foods.
• D. Take this medication with food.

Correct answer: A

Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril. Choices B, C, and D are incorrect because Lisinopril is typically taken once a day in the morning, it can lead to hyperkalemia (so increasing potassium-rich foods is not advised), and it can be taken with or without food.

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