Nursing Elites

1. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Somnolence. Somnolence can indicate lactic acidosis, a rare but serious adverse effect of Metformin. Lactic acidosis is manifested by extreme drowsiness, hyperventilation, and muscle pain. Clients should be instructed to report these symptoms to their healthcare provider promptly to prevent further complications.

2. A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?

• A. Reflex tachycardia
• B. Dizziness
• C. Hyponatremia
• D. Hypotension

Correct answer: C

Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.

3. A client is receiving discharge instructions for a new prescription of Warfarin. Which of the following over-the-counter medications should the client be instructed to avoid?

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

Correct answer: B

Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. Patients on Warfarin should avoid NSAIDs like Ibuprofen and opt for alternative pain relief options to prevent potential complications such as an increased risk of bleeding. Acetaminophen (Choice A), Diphenhydramine (Choice C), and Loratadine (Choice D) are not known to significantly interact with Warfarin in terms of bleeding risk and are generally considered safe to use alongside Warfarin.

4. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication with food.
• B. I will monitor my blood sugar levels while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I can crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing Escitalopram, the client should taper the medication slowly according to a prescribed dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.

5. 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.

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