Nursing Elites

1. A client has a new prescription for Timolol. How should the nurse instruct the client to insert eye drops?

• A. Press your finger on the inside corner of your eye for 1 minute after application.
• B. Apply the eye drops directly to the cornea.
• C. Drop the prescribed amount of medication into the center of the conjunctival sac.
• D. Wipe your eyes gently with a tissue immediately after application.

Correct answer: C

Rationale: When administering eye drops, it is essential to instruct the client to drop the prescribed amount of medication into the center of the conjunctival sac. This technique helps ensure proper distribution of the medication and reduces the risk of potential adverse effects. Pressing on the inside corner of the eye is done to prevent systemic absorption, applying drops directly to the cornea can cause irritation, and wiping the eyes after application can lead to decreased effectiveness of the medication.

2. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots forming and leading to serious complications like pulmonary embolism. Clients with a history of deep-vein thrombosis are at a higher risk of recurrent thromboembolic events when taking tamoxifen, making it unsafe for such individuals. Choices B, C, and D are not contraindications for tamoxifen therapy, as migraine headaches, hypertension, and anemia do not directly interact with tamoxifen's mechanism of action or pose significant risks when used together.

3. When educating a client who has a prescription for Levothyroxine, which instruction should the nurse include?

• A. Take this medication on an empty stomach.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction for taking Levothyroxine is on an empty stomach. This helps to enhance the absorption and effectiveness of the medication. Consuming it with food or antacids can impede its absorption, leading to decreased efficacy.

4. A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bed.
• B. Monitor for increased blood pressure.
• C. Take the medication on an empty stomach.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.

5. A client is starting a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Weigh yourself daily.
• C. Take potassium supplements as needed.
• D. Decrease intake of foods high in sodium.

Correct answer: B

Rationale: When a client is prescribed furosemide, it is important to monitor for fluid loss. Weighing oneself daily helps track changes in weight due to fluid loss, which can indicate the effectiveness of the medication. This monitoring assists in managing fluid balance and adjusting the dosage if necessary to achieve the desired therapeutic effect. Choice A is incorrect because furosemide is usually recommended to be taken on an empty stomach. Choice C is incorrect because potassium supplements should only be taken if prescribed by a healthcare provider due to the risk of hyperkalemia with furosemide. Choice D is incorrect because decreasing sodium intake is generally a good dietary practice but not a specific instruction related to furosemide therapy.

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