Nursing Elites

1. A client has a new prescription for atenolol. Which of the following findings should the nurse instruct the client to monitor for as an adverse effect of this medication?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: Atenolol is a beta-blocker that works by slowing down the heart rate. An adverse effect of atenolol is bradycardia, characterized by a slower than normal heart rate. The nurse should instruct the client to monitor for signs of bradycardia, such as a slow heart rate, while taking atenolol. Therefore, the correct answer is to monitor for bradycardia. Tachycardia (Choice A) is not an expected adverse effect of atenolol as it actually reduces heart rate. Hypoglycemia (Choice B) is not a typical adverse effect of atenolol. Hypertension (Choice D) is not an adverse effect of atenolol, as atenolol is commonly used to manage hypertension.

2. A client is being discharged with a new prescription for Lisinopril. Which of the following instructions should be included by the healthcare provider?

• 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's essential to avoid salt substitutes that may contain potassium which can further elevate potassium levels. Choice B is incorrect because Lisinopril is typically taken once daily in the morning, not at bedtime. Choice C is incorrect as increasing potassium intake can exacerbate hyperkalemia when taking Lisinopril. Choice D is incorrect as Lisinopril is usually taken on an empty stomach, not with food.

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

• A. Take the medication with a full glass of water after rising in the morning.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication with a meal to reduce gastric irritation.
• D. Crush the tablet and mix it with applesauce if difficulty swallowing.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water after rising in the morning to prevent esophageal irritation. It is important to remain upright for at least 30 minutes after taking the medication to reduce the risk of esophageal irritation and ensure proper absorption. Taking the medication with a meal or crushing the tablet are not recommended instructions for alendronate administration. Choice A is the correct answer as it aligns with the proper administration guidelines for alendronate.

4. A healthcare professional in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?

• A. Isosorbide
• B. Phenytoin
• C. Metronidazole
• D. Prednisone

Correct answer: A

Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Isosorbide is a nitrate that can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Therefore, it is essential to avoid concurrent use of isosorbide and sildenafil to prevent adverse effects. Phenytoin, metronidazole, and prednisone do not have significant interactions with sildenafil and are not contraindicated when used together.

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

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct answer is to instruct the client to brush and floss their teeth regularly. Phenytoin can lead to gingival hyperplasia, making oral hygiene crucial to prevent complications. Encouraging good oral care practices helps reduce the risk of adverse effects on the gums and teeth. Avoiding grapefruit juice is not specifically related to Phenytoin. While some medications require intake with food, Phenytoin is usually taken on an empty stomach for better absorption. Increasing calcium-rich foods is not directly associated with Phenytoin therapy.

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