Nursing Elites

1. A client with hypertension is prescribed enalapril (Vasotec). The nurse should monitor the client for which adverse effect?

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

Correct answer: A

Rationale: Enalapril, an ACE inhibitor, can lead to hypotension, particularly following the initial dose or dosage escalation. This effect is due to the medication's mechanism of action in dilating blood vessels, which can result in lowered blood pressure. Monitoring for hypotension is crucial to prevent complications such as dizziness, lightheadedness, or fainting in clients taking enalapril. Choices B, C, and D are incorrect because enalapril does not typically cause hypertension, tachycardia, or hyperglycemia as adverse effects.

2. A client with peripheral arterial disease complains of leg pain while walking. The nurse should reinforce which teaching point with the client?

• A. Wear compression stockings daily.
• B. Increase daily walking distance gradually.
• C. Elevate legs above heart level when resting.
• D. Use a heating pad to soothe leg muscles.

Correct answer: B

Rationale: For clients with peripheral arterial disease experiencing leg pain while walking, the priority teaching point is to gradually increase daily walking distance. This approach helps improve circulation, build tolerance, and reduce symptoms over time. While compression stockings can be beneficial for circulation, they are not the priority teaching point in this scenario. Elevating legs above heart level when resting is more appropriate for clients with venous insufficiency, not peripheral arterial disease. Using a heating pad is not recommended as it can potentially cause burns or skin damage in clients with compromised circulation.

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

• A. Take the medication on an empty stomach.
• B. Avoid drinking alcohol.
• C. Take the medication with an antacid.
• D. Increase your intake of leafy green vegetables.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid drinking alcohol. Isoniazid can cause liver damage, and alcohol consumption can increase this risk. Therefore, it is crucial to avoid alcohol while taking isoniazid to prevent potential liver complications. Choice A is incorrect because isoniazid is typically taken with food to reduce gastrointestinal upset. Choice C is incorrect because antacids can decrease the absorption of isoniazid. Choice D is incorrect as there is no specific recommendation to increase leafy green vegetable intake when taking isoniazid.

4. When educating a client about the use of risedronate to treat osteoporosis, which instruction should be included?

• A. Drink a full glass of water with each dose.
• B. Take the medication on an empty stomach.
• C. Remain upright for 30 minutes after taking the medication.
• D. Avoid lying down for at least 1 hour after taking the medication.

Correct answer: C

Rationale: The correct instruction for a client taking risedronate to treat osteoporosis is to remain upright for 30 minutes after taking the medication. This is important to prevent esophageal irritation, as risedronate can cause irritation if it remains in contact with the esophagus. By staying upright, the medication is more likely to reach the stomach quickly and reduce the risk of irritation to the esophagus. Choices A, B, and D are incorrect. Drinking a full glass of water is recommended, not milk, to help with swallowing the medication. Risedronate should be taken on an empty stomach, not with meals, to ensure proper absorption. Additionally, avoiding lying down for at least 1 hour after taking the medication helps prevent esophageal irritation.

5. When teaching a client about the use of lisinopril, which of the following instructions should the nurse include?

• A. Monitor your blood pressure regularly.
• B. Take the medication with food.
• C. Increase your intake of potassium-rich foods.
• D. Avoid grapefruit juice.

Correct answer: A

Rationale: The correct answer is to instruct the client to monitor their blood pressure regularly when taking lisinopril. Lisinopril is known to cause hypotension, so monitoring blood pressure is crucial to ensure it stays within a safe range. This monitoring helps in early detection of any potential issues related to low blood pressure, allowing for timely intervention. Choices B, C, and D are incorrect because taking lisinopril with food, increasing potassium-rich foods intake, and avoiding grapefruit juice are not specific instructions related to the safe and effective use of lisinopril.

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