Nursing Elites

1. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: The correct instruction for taking Colesevelam is to take it with food and at least one glass of water. This helps to ensure proper absorption and reduce the risk of gastrointestinal side effects. Option A is incorrect because Digoxin and Colesevelam should not be taken together. Option B is irrelevant to the administration of Colesevelam. Option C is unrelated to the specific instructions for taking Colesevelam.

2. When teaching a client with a new prescription for nitroglycerin patches, which of the following instructions should the nurse include?

• A. Apply the patch at the same time every day.
• B. Rotate the application site daily.
• C. Remove the patch for 12 hours each day.
• D. Cut the patch in half if needed.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for nitroglycerin patches is to rotate the application site daily. This is important to prevent skin irritation and ensure optimal absorption of the medication. Applying the patch at the same time every day (Choice A) is not necessary for nitroglycerin patches. Removing the patch for 12 hours each day (Choice C) would disrupt the continuous delivery of medication. Cutting the patch in half (Choice D) can alter the dose and is not recommended unless directed by a healthcare provider.

3. 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, which is manifested by extreme drowsiness, hyperventilation, and muscle pain. It is a rare but very serious adverse effect caused by metformin and should be reported to the provider promptly to prevent further complications.

4. A client is prescribed Diltiazem. Which of the following findings should the nurse monitor?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperkalemia

Correct answer: B

Rationale: Diltiazem is a calcium channel blocker that can lead to bradycardia as an adverse effect due to its negative chronotropic and dromotropic effects on the heart. The nurse should monitor the client's heart rate regularly to detect any signs of bradycardia and take appropriate actions if necessary. Tachycardia (Choice A) is not an expected finding with Diltiazem use. Hypertension (Choice C) is actually a condition that Diltiazem is used to treat. Hyperkalemia (Choice D) is not a common adverse effect of Diltiazem.

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

• A. Take the medication in the morning.
• B. Increase your intake of potassium-rich foods.
• C. Expect your urine to turn orange.
• D. Avoid prolonged sunlight exposure.

Correct answer: B

Rationale: The correct answer is B: 'Increase your intake of potassium-rich foods.' Furosemide is a loop diuretic that can lead to hypokalemia (low potassium levels) due to increased excretion of potassium in the urine. To counteract this effect and maintain electrolyte balance, the client should be advised to increase their intake of potassium-rich foods. This instruction helps prevent potential complications associated with low potassium levels. Choices A, C, and D are incorrect. Taking Furosemide in the morning does not affect its effectiveness; urine turning orange is not an expected side effect of Furosemide; and avoiding prolonged sunlight exposure is not directly related to Furosemide use.

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