Nursing Elites

1. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?

• A. Discontinue the medication if a rash develops.
• B. Expect increased salivation during the first few weeks of therapy.
• C. Avoid driving until the client's reaction to the medication is known.
• D. Stop the medication if you experience a dry mouth.

Correct answer: C

Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so it is important for the client to refrain from activities that require alertness until they are aware of how the medication affects them. Choice A is incorrect because a rash is not a common side effect of clonidine. Choice B is incorrect as increased salivation is not an expected side effect of clonidine. Choice D is also incorrect as dry mouth is a common side effect of clonidine, but it is not a reason to stop the medication unless severe or bothersome. Therefore, the priority instruction for the nurse to include is to advise the client to avoid driving until their reaction to the medication is known to ensure safety.

2. A client has a new prescription for Calcitonin-Salmon for Osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Administer the medication intramuscularly.
• B. Swallow the medication whole.
• C. Inject the medication subcutaneously.
• D. Expect nasal bleeding with this medication.

Correct answer: C

Rationale: When teaching a client about Calcitonin-Salmon for Osteoporosis, the nurse should include instructions to inject the medication subcutaneously or administer it intranasally. Option A is incorrect because Calcitonin-Salmon is not typically administered intramuscularly. Option B is incorrect because it is not meant to be swallowed. Option D is incorrect as nasal bleeding is not an expected side effect with this medication.

3. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following over-the-counter medications should the provider instruct the client to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs like ibuprofen and opt for alternative pain relief options such as acetaminophen. Diphenhydramine and loratadine are antihistamines and are generally safe to use with Warfarin as they do not significantly increase the risk of bleeding when compared to NSAIDs like ibuprofen.

4. A client is receiving heparin therapy. Which laboratory value should be monitored by the nurse to evaluate the effectiveness of the therapy?

• A. PT
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The activated partial thromboplastin time (aPTT) is specifically used to monitor the effectiveness of heparin therapy. It should be maintained at 1.5 to 2 times the normal level. Monitoring aPTT helps ensure that the therapeutic range of heparin is achieved to prevent clot formation while minimizing the risk of bleeding complications. Choice A (PT) is incorrect as it is used to monitor warfarin therapy, not heparin. Choice C (INR) is also incorrect as it is primarily used to monitor warfarin therapy. Choice D (Platelet count) is not directly related to monitoring the effectiveness of heparin therapy.

5. A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bed.
• B. Monitor for increased blood pressure.
• C. Take the medication on an empty stomach.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.

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