Nursing Elites

1. A client has a new prescription for atenolol. Which of the following instructions should be included in the discharge teaching?

• A. Take the medication at bedtime.
• B. Monitor your heart rate daily.
• C. Increase your intake of potassium-rich foods.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is to instruct the client to monitor their heart rate daily when taking atenolol. Atenolol can lead to bradycardia, a slow heart rate. By monitoring heart rate daily, the client can promptly identify any significant changes and seek medical attention if necessary. This proactive approach enables early detection of potential adverse effects of atenolol, contributing to the client's safety and well-being. Choices A, C, and D are incorrect because taking atenolol at bedtime, increasing potassium-rich foods intake, or avoiding dairy products are not specific instructions related to the potential side effects of atenolol.

2. A client with a history of heart failure is prescribed metoprolol (Lopressor). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Hypotension
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: Metoprolol is a beta-blocker commonly used in heart failure to reduce blood pressure. One of the common side effects of metoprolol is hypotension, which can lead to dizziness, lightheadedness, and even fainting. Therefore, monitoring for hypotension is essential to prevent adverse effects and ensure patient safety. Choices A, C, and D are incorrect. Tachycardia is not a common side effect of metoprolol, as it actually reduces heart rate. Hypertension is also not a common side effect of this medication, as it is intended to lower blood pressure. Hyperglycemia is not a typical side effect of metoprolol.

3. A client has a new prescription for alendronate. Which of the following instructions should be included in the teaching?

• 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: The correct instruction for taking alendronate is to take it with a full glass of water to prevent esophageal irritation. This helps ensure proper absorption and reduces the risk of irritation to the esophagus. Choice B is incorrect because patients should remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation. Choice C is incorrect as alendronate should be taken in the morning on an empty stomach. Choice D is also incorrect as there is no specific requirement to avoid dairy products while taking alendronate.

4. The client with a history of left-sided heart failure is exhibiting increasing shortness of breath and frothy sputum. What is the priority nursing action?

• A. Administer oxygen
• B. Encourage coughing and deep breathing
• C. Place the client in a supine position
• D. Notify the healthcare provider immediately

Correct answer: A

Rationale: Shortness of breath and frothy sputum are indicative of pulmonary edema, a serious condition that requires immediate intervention to improve oxygenation. Administering oxygen is the priority action to support the client's respiratory function and prevent further deterioration. Oxygen therapy helps increase the oxygen levels in the blood, alleviate respiratory distress, and support vital organ function. Prompt intervention with oxygen can help stabilize the client while further assessments and treatments are initiated. Encouraging coughing and deep breathing may worsen the client's condition by increasing respiratory effort. Placing the client in a supine position can further compromise breathing in a client with pulmonary edema. Notifying the healthcare provider is important but not the priority when the client's respiratory status is deteriorating.

5. A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should reinforce which dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase intake of dairy products.
• C. Limit intake of foods high in fiber.
• D. Increase protein intake.

Correct answer: A

Rationale: The correct answer is to avoid foods high in vitamin K. Clients taking warfarin (Coumadin) should maintain a consistent intake of vitamin K to keep the medication's effectiveness stable. Foods high in vitamin K, such as leafy greens, can interfere with the anticoagulant effects of warfarin. Therefore, it is crucial for clients to avoid these foods to ensure the therapeutic effects of warfarin. Choices B, C, and D are incorrect because increasing dairy products, limiting fiber intake, or increasing protein intake do not directly impact the effectiveness of warfarin therapy and are not necessary dietary modifications for clients on this medication.

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