a nurse is providing teaching to a client who is starting therapy with metformin which of the following instructions should the nurse include

ATI RN

ATI Pharmacology Proctored Exam 2019

1. A client is starting therapy with Metformin. Which of the following instructions should the nurse include?

A. Take this medication with your first bite of food.
B. Take this medication on an empty stomach.
C. Take this medication before bedtime.
D. Take this medication every other day.

Correct answer: A

Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. Instructing the client to take the medication with the first bite of food helps in achieving optimal effectiveness and minimizes the risk of side effects like nausea or upset stomach. Choice B is incorrect because taking Metformin on an empty stomach can lead to increased gastrointestinal side effects. Choice C is incorrect as there is no specific timing requirement for taking Metformin before bedtime. Choice D is incorrect as Metformin is usually taken daily, not every other day.

2. What is a severe adverse effect of iron supplementation?

A. Seizures
B. Dry mouth
C. Edema
D. Serotonin syndrome

Correct answer: A

Rationale: A severe adverse effect of iron supplementation is seizures. Iron toxicity can lead to symptoms such as abdominal pain, vomiting, bloody diarrhea, lethargy, and in severe cases, seizures. It is important for individuals taking iron supplements to follow recommended dosages to prevent adverse effects.

3. When educating a client who has a prescription for Propranolol, what instruction should the healthcare provider include?

A. Take this medication with food.
B. Discontinue the medication if you feel fatigued.
C. Expect to have decreased heart rate with this medication.
D. Do not stop taking this medication abruptly.

Correct answer: D

Rationale: The correct instruction for a client with a prescription for Propranolol is not to stop taking the medication abruptly. Abrupt cessation can result in rebound hypertension or other cardiac complications. It is crucial for the client to taper off the medication gradually under healthcare provider supervision to prevent adverse effects. Choice A is incorrect because Propranolol can be taken with or without food. Choice B is incorrect as discontinuing the medication based on fatigue alone is not advisable without consulting a healthcare provider. Choice C is incorrect because while Propranolol can decrease heart rate, it is not the primary instruction to provide in this scenario.

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. What is the therapeutic use of Phenytoin?

A. Replacement in hypothyroidism to restore normal hormonal balance
B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
C. Diminished seizure activity, termination of ventricular arrhythmias
D. Prevention of thrombus formation, prevention of extension of existing thrombi

Correct answer: C

Rationale: Phenytoin is primarily used to diminish seizure activity and is effective in terminating ventricular arrhythmias. It works by stabilizing neuronal membranes, reducing repetitive neuronal firing, and limiting the spread of seizure activity in the brain. While phenytoin does not have a direct role in preventing thrombus formation or extending existing thrombi, it is crucial in managing seizures and certain arrhythmias.