Nursing Elites

1. A nurse is providing teaching to a client who has asthma and is beginning to take montelukast. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will use this medication as a rescue inhaler during asthma attacks.
• B. I should take this medication once daily in the evening.
• C. I need to have my blood levels checked regularly while taking this medication.
• D. I should take this medication before exercising to prevent bronchospasm.

Correct answer: B

Rationale: Montelukast is typically taken once daily in the evening for long-term control of asthma symptoms. It helps prevent asthma attacks by reducing inflammation in the airways. While montelukast can also be used for exercise-induced bronchospasm in some cases, it is generally not a rescue medication and should be taken regularly, not on an as-needed basis.

2. A client is prescribed Metformin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin A1c
• D. Serum creatinine

Correct answer: D

Rationale: The correct answer is D: Serum creatinine. Metformin can potentially cause lactic acidosis, particularly in patients with impaired renal function. Monitoring serum creatinine levels is crucial to assess kidney function and detect any adverse effects of Metformin on renal health. Choices A, B, and C are incorrect as blood glucose, creatine kinase, and hemoglobin A1c levels are not directly monitored to assess for potential adverse effects of Metformin. Blood glucose monitoring is typically done to assess the efficacy of antidiabetic medications like Metformin, while creatine kinase levels are indicative of muscle damage and hemoglobin A1c reflects long-term blood sugar control.

3. A client with Schizophrenia is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

• A. Increase your intake of snacks to prevent weight loss.
• B. Notify the provider if you develop breast enlargement.
• C. Be aware of the possibility of mild seizures while taking this medication.
• D. Expect an increase in libido when taking this medication.

Correct answer: B

Rationale: The correct instruction the nurse should provide to the client taking Risperidone for Schizophrenia is to notify the provider if they develop breast enlargement. Risperidone can lead to an increase in prolactin levels, causing gynecomastia (breast enlargement) and galactorrhea. Therefore, it is crucial for the client to report these manifestations to the healthcare provider for appropriate management. Choices A, C, and D are incorrect. Increasing snack intake to prevent weight loss is not a specific concern related to Risperidone. Mild seizures are not a common side effect of Risperidone, so this instruction is unnecessary. Risperidone is more likely to cause sexual side effects like decreased libido rather than an increase.

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

• A. This medication may cause dry mouth.
• B. You should avoid drinking grapefruit juice.
• C. You may experience a rapid heart rate.
• D. Increase your intake of fiber-rich foods.

Correct answer: B

Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.

5. A client has a new prescription for Aspirin for the prevention of myocardial infarction. Which of the following findings should be identified as an adverse effect?

• A. Nausea
• B. Bruising
• C. Dizziness
• D. Dry mouth

Correct answer: B

Rationale: Bruising is an adverse effect to be monitored when a client is prescribed Aspirin for the prevention of myocardial infarction due to its association with increased bleeding risk. Aspirin's antiplatelet effect can lead to bruising and other signs of bleeding, necessitating close observation to prevent complications. Nausea, dizziness, and dry mouth are not typically recognized adverse effects of Aspirin therapy for myocardial infarction prevention.

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