Nursing Elites

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

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.

2. When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?

• A. Expect the development of a mild rash.
• B. Take the medication on an empty stomach.
• C. Monitor for signs of gingival hyperplasia.
• D. Increase your intake of calcium.

Correct answer: C

Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.

3. A patient is being discharged with a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bedtime.
• B. Monitor for increased blood pressure.
• C. Take the medication with food.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct instruction the nurse should include is to monitor for leg cramps. Leg cramps can be a sign of hypokalemia, which is a potential adverse effect of Hydrochlorothiazide. By monitoring for leg cramps, the patient can detect signs of low potassium levels and report them to the healthcare provider promptly. This proactive approach helps prevent complications associated with hypokalemia. The other options are incorrect because taking Hydrochlorothiazide before bedtime or with food is not specific to the medication's adverse effects. Monitoring for increased blood pressure is not typically a common adverse effect of this medication.

4. A client has a new prescription for Ranitidine to treat peptic ulcer disease. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid smoking while taking this medication.
• C. Increase intake of dairy products.
• D. Expect a yellow tinge to the skin.

Correct answer: B

Rationale: The correct instruction that the nurse should include for a client prescribed Ranitidine to treat peptic ulcer disease is to avoid smoking while taking the medication. Smoking can interfere with the effectiveness of ranitidine and worsen ulcer symptoms. Therefore, it is crucial for clients to abstain from smoking to ensure optimal therapeutic outcomes. Choices A, C, and D are incorrect. Taking Ranitidine with or without food does not significantly affect its effectiveness, there is no specific need to increase intake of dairy products, and expecting a yellow tinge to the skin is not a common side effect associated with Ranitidine.

5. A client in the operating room received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and their body temperature begins to rise. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are manifestations of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic activity and treat malignant hyperthermia effectively. Neostigmine (choice A) is used to reverse the effects of non-depolarizing neuromuscular blockers, not to treat malignant hyperthermia. Naloxone (choice B) is an opioid antagonist used for opioid overdose. Vecuronium (choice D) is a non-depolarizing neuromuscular blocker and is not used to treat malignant hyperthermia.

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