Nursing Elites

1. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify the trough levels of a medication accurately, the nurse should obtain a blood specimen immediately before administering the next dose of the medication. The trough level represents the lowest concentration of the medication in the bloodstream, typically right before the next dose is due. This timing ensures an accurate assessment of the drug's concentration in the body at its lowest point, aiding in determining the drug's effectiveness and potential toxicity levels. Choice B is incorrect because waiting for 24 hours would not provide the trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect as obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level.

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

• A. Notify the provider if you plan to become pregnant.
• B. Take the medication 1 hr before you plan to go to sleep.
• C. Allow at least 6 hr for sleep when taking Zolpidem.
• D. To increase the effectiveness of Zolpidem, take it with a bedtime snack.

Correct answer: A

Rationale: Zolpidem is classified under Pregnancy Risk Category C. It is essential for the client to inform the provider if she plans to become pregnant as Zolpidem use during pregnancy may pose risks to the fetus. This precaution allows for appropriate assessment and possible adjustments to the treatment plan to ensure the safety of both the client and the developing baby. Choice B is incorrect because Zolpidem is usually taken immediately before bedtime, not 1 hour before. Choice C is incorrect as Zolpidem is known for its quick onset of action, and the client does not need to allocate a specific amount of time for sleep. Choice D is incorrect as taking Zolpidem with food, especially a bedtime snack, may delay its onset of action.

3. When educating a client with a new prescription for Amlodipine, which instruction should the nurse provide?

• A. Increase your intake of dairy products.
• B. Avoid driving until you see how the medication affects you.
• C. Stop taking the medication if you develop a dry cough.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid driving until they understand the medication's effects. Amlodipine can cause dizziness, making it unsafe to drive until the client knows how the medication affects them. This instruction promotes client safety and prevents potential accidents due to medication side effects.

4. 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.

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

• A. Expect a rapid heart rate.
• B. Take the medication with meals.
• C. Report any signs of restlessness or involuntary movements.
• D. Avoid consuming dairy products.

Correct answer: C

Rationale: The correct instruction to include when teaching a client about Metoclopramide is to report any signs of restlessness or involuntary movements. Metoclopramide can lead to extrapyramidal symptoms, such as restlessness or involuntary movements. It is essential for clients to notify their healthcare provider if they experience these symptoms to receive appropriate management.

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