Nursing Elites

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

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Increase your fluid intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client starting Metoprolol is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, leading to dizziness and falls if the client changes positions quickly. By advising the client to make position changes slowly, the nurse helps prevent these adverse effects and promotes safety.

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

• A. Take the medication with an antacid.
• B. Avoid drinking coffee while taking this medication.
• C. Take the medication at bedtime.
• D. Stop the medication if you develop a headache.

Correct answer: C

Rationale: The correct instruction for a client prescribed Ranitidine is to take the medication at bedtime. Ranitidine is best taken at night to reduce nighttime stomach acid production, providing optimal relief for conditions like gastroesophageal reflux disease (GERD) and ulcers.

3. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following herbal supplements 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 can reduce the effectiveness of Warfarin by interacting with its metabolism pathways, potentially leading to decreased anticoagulant effects. Therefore, clients on Warfarin therapy should avoid St. John's wort. While echinacea, garlic, and ginseng are also herbal supplements that can interact with Warfarin, St. John's wort is particularly known for its significant impact on Warfarin metabolism. Echinacea may increase the risk of bleeding when taken with Warfarin, garlic may potentiate the anticoagulant effects of Warfarin, and ginseng may also increase the risk of bleeding. However, St. John's wort is the most crucial to avoid due to its significant impact on Warfarin metabolism.

4. A client has been prescribed Phenelzine for depression. Which of the following indicates that the client has developed an adverse effect of this medication?

• A. Orthostatic hypotension
• B. Hearing loss
• C. Gastrointestinal bleeding
• D. Weight loss

Correct answer: A

Rationale: Orthostatic hypotension is a known adverse effect of Phenelzine, a monoamine oxidase inhibitor (MAOI) used for depression. It is caused by a sudden drop in blood pressure when changing positions, leading to symptoms like dizziness or fainting. Monitoring for orthostatic hypotension is crucial during Phenelzine therapy to prevent complications. Choices B, C, and D are incorrect because hearing loss, gastrointestinal bleeding, and weight loss are not typically associated with Phenelzine use.

5. A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?

• A. A headache indicates a serious allergic reaction to nitroglycerin.
• B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
• C. Nitroglycerin does not cause a headache.
• D. The most common side effect of nitroglycerin is a headache.

Correct answer: D

Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.

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