Nursing Elites

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. A client is prescribed gentamicin for an infection. Which finding indicates a potential adverse reaction to the medication?

• A. Blood pressure 160/90 mm Hg
• B. Presence of red blood cells in the urine
• C. Urine output of 35 mL/hr
• D. Respiratory rate of 22/min

Correct answer: B

Rationale: The presence of red blood cells in the urine is a significant finding that can indicate nephrotoxicity, a potential adverse effect of gentamicin. Nephrotoxicity can lead to kidney damage, and monitoring for this adverse reaction is crucial during gentamicin therapy. Elevated blood pressure (Choice A) is not typically associated with gentamicin adverse reactions. Decreased urine output (Choice C) may suggest kidney impairment but is not as specific as the presence of red blood cells in the urine. Respiratory rate (Choice D) is not directly related to potential adverse reactions to gentamicin.

3. A client has a prescription for hydrochlorothiazide to treat hypertension. The nurse should monitor the client for which of the following adverse effects?

• A. Hypokalemia
• B. Hypertension
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: Hydrochlorothiazide is a diuretic that can cause potassium loss, leading to hypokalemia. Monitoring potassium levels is crucial to prevent potential adverse effects such as cardiac arrhythmias and muscle weakness.

4. When teaching a client with a prescription for Loperamide for diarrhea, which instruction should the nurse include?

• A. Take the medication with a full glass of water.
• B. Avoid activities that require alertness.
• C. Expect abdominal pain and bloating.
• D. Take an additional dose after each loose stool.

Correct answer: B

Rationale: The correct instruction the nurse should include when teaching a client with a prescription for Loperamide is to 'Avoid activities that require alertness.' Loperamide can cause drowsiness, so clients should avoid such activities until they know how the medication affects them.

5. A client has a new prescription for Clonidine. Which of the following instructions should the nurse include?

• A. Expect to feel drowsy.
• B. Increase your intake of high-potassium foods.
• C. Take the medication with grapefruit juice.
• D. Avoid foods high in fat.

Correct answer: A

Rationale: The correct answer is to expect to feel drowsy. Clonidine is known to cause drowsiness, especially at the beginning of treatment. It is important for clients to be cautious with activities that require alertness until they understand how the medication affects them. Choice B is incorrect as there is no specific need to increase high-potassium foods with Clonidine. Choice C is incorrect as grapefruit juice can interact with many medications but is not a typical instruction for Clonidine. Choice D is incorrect as there is no specific indication to avoid foods high in fat with Clonidine.

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