Nursing Elites

1. Why should the nitrate patch be off for 8 hours per day?

• A. “There is no reason to take the patch off each day.”
• B. “The patch can be addictive; leaving it off reduces the addiction.”
• C. “You should only leave the patch off for 15 minutes.”
• D. “Leaving the patch off for 8 hours per day helps to delay the development of tolerance.”

Correct answer: D

Rationale: Removing the nitrate patch for 8 hours each day is essential to prevent the body from developing tolerance to the medication. By allowing the body to have a drug-free period, the effectiveness of the medication is maintained over time. This practice helps in ensuring that the nitrate patch continues to provide its intended therapeutic effects without diminishing its efficacy. Therefore, it is important for the client to adhere to the prescribed schedule of removing the patch for 8 hours daily to optimize the treatment outcomes.

2. When teaching a client with a new prescription for Ramelteon, which of the following foods should the nurse instruct the client to avoid?

• A. Baked potato
• B. Fried chicken
• C. Whole-grain bread
• D. Citrus fruits

Correct answer: B

Rationale: The correct answer is B: Fried chicken. High-fat foods, like fried chicken, can delay the absorption of Ramelteon. It is important for the client to avoid such foods to ensure the medication's effectiveness. Baked potato, whole-grain bread, and citrus fruits do not have a significant interaction with Ramelteon and can be consumed safely while taking the medication.

3. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?

• A. Dry cough
• B. Weight gain
• C. Diarrhea
• D. Nausea

Correct answer: A

Rationale: A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. This cough is a result of increased bradykinin levels due to ACE inhibition. The client should be educated to monitor for a dry cough and notify the healthcare provider if it occurs, as it may indicate the need for a medication adjustment. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not commonly associated adverse effects of Enalapril.

4. A client has a new prescription for Alendronate to treat osteoporosis. Which of the following instructions should the nurse include?

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

Correct answer: A

Rationale: The correct instruction is to take Alendronate with a full glass of water after rising in the morning. This helps reduce the risk of esophageal irritation, as the medication can cause irritation if not taken correctly. Taking it before bedtime (choice C) can increase the risk of irritation as the individual lies down. Lying down after taking the medication (choice B) can also lead to esophageal irritation. Crushing the tablet (choice D) is not recommended as Alendronate should be taken whole with a full glass of water.

5. A client has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?

• A. Orthostatic hypotension
• B. Increased heart rate
• C. Dark-colored urine
• D. Persistent cough

Correct answer: B

Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.

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