Nursing Elites

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

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect decreased urination within the first few days.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Hydrochlorothiazide is a diuretic that can lead to hypokalemia by increasing potassium excretion. Therefore, instructing the client to increase their intake of potassium-rich foods is essential to prevent electrolyte imbalances and support overall health. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning is not directly related to the medication's mechanism of action. Expecting decreased urination within the first few days is not accurate as the medication is a diuretic that typically increases urination. Also, advising the client to avoid foods high in potassium would not be suitable, as increasing potassium-rich foods is necessary to counteract potential potassium depletion caused by Hydrochlorothiazide.

2. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Take off the nitroglycerin patch if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half is not recommended because it can alter the dosing and absorption rate, leading to inadequate symptom control. Taking off the patch for a headache is not necessary as headaches are a common side effect that may improve with continued use. Applying a new patch every 48 hours is not correct as it may not provide continuous symptom relief for angina.

3. A client is taking atorvastatin for hyperlipidemia. Which of the following findings should the nurse report to the provider immediately?

• A. Headache
• B. Nausea
• C. Muscle pain
• D. Diarrhea

Correct answer: C

Rationale: Muscle pain should be reported immediately as it can indicate rhabdomyolysis, a severe adverse effect of atorvastatin. Rhabdomyolysis is characterized by muscle pain, weakness, and can lead to serious complications such as kidney damage, making it crucial for the nurse to notify the provider promptly. Headache, nausea, and diarrhea are common side effects of atorvastatin and do not require immediate reporting unless severe or persistent.

4. When providing discharge instructions to a client prescribed Warfarin, which herbal supplement should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by interacting with its metabolism. While garlic and ginseng are also known to interact with Warfarin, the specific supplement the nurse should instruct the client to avoid in this scenario is St. John's wort. Echinacea, although an herbal supplement, is not typically associated with significant interactions with Warfarin and is not the primary concern in this case.

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

• A. Take this medication with food.
• B. Take this medication at bedtime.
• C. Take this medication on an empty stomach.
• D. Take this medication with antacids.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach to increase absorption and efficacy. Taking it with food or antacids can interfere with its absorption, affecting the medication's effectiveness.

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