a client with chronic obstructive pulmonary disease copd is prescribed tiotropium spiriva which instruction should the nurse include in the teaching p
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Nursing Elites

HESI RN

Pharmacology HESI

1. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?

Correct answer: B

Rationale: Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.

2. The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:

Correct answer: B

Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.

3. A healthcare professional is planning to administer amlodipine (Norvasc) to a client. The healthcare professional plans to check which of the following before giving the medication?

Correct answer: B

Rationale: Before administering amlodipine, it is important to check the client's blood pressure and heart rate. Amlodipine is known to lower blood pressure and heart rate as part of its mechanism of action. Monitoring these vital signs helps ensure the safety of the client and allows for appropriate assessment of the medication's effects post-administration.

4. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching plan?

Correct answer: B

Rationale: The correct instruction for the nurse to include in the client's teaching plan when taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. It is important for the client to promptly report any signs of infection to receive timely medical intervention. Choice A is incorrect because folic acid supplements are often recommended to reduce side effects of methotrexate. Choice C is incorrect as methotrexate is usually taken on an empty stomach unless the client experiences gastrointestinal upset. Choice D is incorrect as there is no need to limit fluid intake while on methotrexate; in fact, maintaining adequate fluid intake is important to prevent complications such as kidney damage.

5. When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?

Correct answer: B

Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.

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