Nursing Elites

1. A client diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforce in this client's teaching?

• A. Discontinue the medication if dizziness occurs.
• B. Avoid getting up quickly. Always rise slowly.
• C. Take the medication with or without food.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct instruction that the practical nurse should reinforce with a client prescribed nitrate isosorbide dinitrate is to avoid getting up quickly and to rise slowly. Nitrates can cause orthostatic hypotension, a sudden drop in blood pressure when changing positions. By rising slowly, the client can prevent the occurrence of orthostatic hypotension and its associated symptoms. Choices A, C, and D are incorrect because discontinuing the medication without consulting a healthcare provider can be dangerous, taking the medication with or without food does not impact its effectiveness, and increasing potassium intake is not directly related to the use of nitrate isosorbide dinitrate.

2. A client with chronic heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an excess of potassium in the body, resulting in hyperkalemia. This side effect is important to monitor in clients taking spironolactone, especially those with chronic heart failure, as hyperkalemia can lead to serious cardiac complications.

3. A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?

• A. Determine if the medication is being taken correctly
• B. Provide instructions on managing these side effects
• C. Schedule an appointment for evaluation by the healthcare provider
• D. Advise stopping the medication until the unpleasant side effects wear off

Correct answer: B

Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.

4. A client who was diagnosed with oral thrush calls the clinic saying the medication bottle broke and all of the medication was spilled. The client is requesting a refill order. The nurse should contact the health care provider about a refill for which medication?

• A. Ampicillin
• B. Ciprofloxacin
• C. Neomycin sulfate
• D. Nystatin

Correct answer: D

Rationale: Nystatin is the appropriate medication for treating oral thrush as it is an antifungal drug specifically used for fungal infections. It targets the fungus responsible for thrush, Candida, effectively. Therefore, the nurse should contact the healthcare provider to request a refill of Nystatin for the client.

5. A client with hypertension is prescribed atenolol. The nurse should monitor the client for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hypotension
• D. Hyperglycemia

Correct answer: A

Rationale: When a client is prescribed atenolol, a beta-blocker medication used to treat hypertension, the nurse should monitor for bradycardia as a potential side effect. Atenolol works by slowing the heart rate, and one common adverse effect is bradycardia, which is a slower than normal heart rate. Monitoring the client's heart rate is essential to detect and manage this potential side effect promptly. Choices B, C, and D are incorrect because atenolol typically does not cause tachycardia, hypotension, or hyperglycemia as primary side effects. Instead, bradycardia is a common concern due to the drug's mechanism of action in reducing heart rate.

Similar Questions