Nursing Elites

1. Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client:

• A. Cut the dose in half.
• B. Discontinue the medication.
• C. Take the medication with food.
• D. Contact the healthcare provider (HCP).

Correct answer: C

Rationale: Isosorbide mononitrate can cause headaches, which usually disappear during continued therapy. Taking the medication with food or meals can help alleviate the headache. It is important to recommend this approach before considering dose adjustments or discontinuation of the medication. Contacting the healthcare provider would be necessary if the headache persists despite taking the medication with food.

2. The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?

• A. Constipation
• B. Abdominal pain
• C. An episode of diarrhea
• D. Hematest-positive nasogastric tube drainage

Correct answer: C

Rationale: Loperamide hydrochloride (Imodium) is an antidiarrheal medication commonly used to manage episodes of diarrhea. It works by slowing down gut movement and reducing the frequency of bowel movements. Loperamide is not indicated for constipation, abdominal pain, or hematest-positive nasogastric tube drainage. It is specifically useful in acute and chronic diarrhea, such as in cases of inflammatory bowel disease, to help control symptoms and decrease fluid loss.

3. A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:

• A. Avoid drinking alcohol.
• B. Report yellow eyes or skin immediately.
• C. Avoid Swiss or aged cheeses.
• D. Avoid vitamin supplements during therapy.

Correct answer: B

Rationale: When a client is on isoniazid (INH) therapy, they should be instructed to report any signs of hepatitis, such as yellowing of the eyes or skin, immediately. Alcohol consumption should be avoided during INH therapy due to the risk of hepatotoxicity. Foods high in tyramine, such as Swiss or aged cheeses, should also be avoided to prevent adverse reactions. Additionally, while on INH therapy, it is essential to avoid vitamin supplements containing pyridoxine (vitamin B6) to prevent potential interactions.

4. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching plan?

• A. Avoid taking folic acid supplements.
• B. Report any signs of infection immediately.
• C. Take the medication with a full meal.
• D. Limit fluid intake while on this medication.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the client's teaching plan when taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. It is important for the client to promptly report any signs of infection to receive timely medical intervention. Choice A is incorrect because folic acid supplements are often recommended to reduce side effects of methotrexate. Choice C is incorrect as methotrexate is usually taken on an empty stomach unless the client experiences gastrointestinal upset. Choice D is incorrect as there is no need to limit fluid intake while on methotrexate; in fact, maintaining adequate fluid intake is important to prevent complications such as kidney damage.

5. A client with type 2 diabetes mellitus is prescribed glipizide (Glucotrol). Which instruction should the nurse include in the teaching plan?

• A. Take the medication before a meal.
• B. Monitor for signs of hypoglycemia.
• C. Avoid alcohol consumption while taking this medication.
• D. Take the medication before bedtime.

Correct answer: B

Rationale: The correct instruction the nurse should include in the teaching plan for a client prescribed glipizide (Glucotrol) is to monitor for signs of hypoglycemia. Glipizide stimulates insulin release from the pancreas, which can lead to hypoglycemia. It is usually taken before a meal, not necessarily on an empty stomach. Alcohol consumption should be avoided to prevent interactions with the medication. Taking the medication before bedtime is not the typical recommendation.

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