Nursing Elites

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

• A. Take the medication with food.
• B. Increase your fluid intake.
• C. Avoid consuming dairy products.
• D. Take the medication in the morning.

Correct answer: B

Rationale: Increasing fluid intake is essential when taking allopurinol to prevent the formation of kidney stones. Allopurinol can increase the levels of uric acid in the body, which can lead to kidney stone formation. By increasing fluid intake, the client can help flush out excess uric acid and prevent the development of kidney stones. It is important to drink plenty of water throughout the day to maintain adequate hydration and reduce the risk of kidney stone formation. Choices A, C, and D are incorrect. Taking allopurinol with food or in the morning does not specifically relate to preventing kidney stone formation. Avoiding dairy products is not a standard recommendation when taking allopurinol.

2. The LPN/LVN is collecting data on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain. During the admission, the client reports chest pain. The nurse should immediately ask the client which question?

• A. Are you having any nausea?
• B. Where is the pain located?
• C. Are you allergic to any medications?
• D. Do you have your nitroglycerin with you?

Correct answer: B

Rationale: In a client with angina pectoris, determining the location of chest pain is crucial for assessing the potential severity and cause. This information helps the nurse to further evaluate the nature of the pain and its probable origin, aiding in timely and appropriate interventions. Choices A, C, and D are not as immediately relevant as determining the location of the chest pain when assessing a client with angina pectoris.

3. A client has a new prescription for digoxin. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Avoid consuming grapefruit juice.
• D. Increase intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Monitor heart rate daily.' When a client is prescribed digoxin, it is essential to monitor heart rate daily because digoxin can cause bradycardia, a condition characterized by a slow heart rate. Monitoring the heart rate regularly allows the client to promptly identify any signs of bradycardia and seek medical attention if needed. Choices A, C, and D are incorrect because taking digoxin with food, avoiding grapefruit juice, and increasing potassium-rich foods are not specific instructions related to managing the side effects or monitoring parameters of digoxin therapy.

4. A client with a diagnosis of angina pectoris is prescribed nitroglycerin. The nurse should teach the client to take the medication in which way?

• A. Take one tablet daily with breakfast
• B. Take one tablet every 5 minutes as needed, up to three times
• C. Take one tablet every hour until pain subsides
• D. Take one tablet only if pain does not subside after 30 minutes

Correct answer: B

Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. This dosing regimen helps in managing acute angina episodes effectively. Choice A is incorrect because nitroglycerin is not taken once daily. Choice C is incorrect because waiting for an hour between doses may not provide timely relief during angina attacks. Choice D is incorrect as it suggests waiting for 30 minutes before taking another dose, which could delay symptom relief in acute situations.

5. In monitoring the effectiveness of warfarin therapy for a client with a history of atrial fibrillation, which laboratory value should the nurse monitor?

• A. Activated partial thromboplastin time (aPTT)
• B. Prothrombin time (PT) and international normalized ratio (INR)
• C. Platelet count
• D. Erythrocyte sedimentation rate (ESR)

Correct answer: B

Rationale: Prothrombin time (PT) and international normalized ratio (INR) are crucial laboratory values to monitor the effectiveness of warfarin therapy in clients with atrial fibrillation. These values help ensure that the client is within the therapeutic range and that the anticoagulant effect of warfarin is appropriate. Monitoring aPTT, platelet count, or ESR is not directly related to assessing the effectiveness of warfarin therapy in these cases.

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