a client with hypertension is prescribed losartan cozaar which instruction should the nurse include in the teaching plan

HESI RN

Pharmacology HESI Quizlet

1. A client with hypertension is prescribed losartan (Cozaar). Which instruction should the nurse include in the teaching plan?

A. Avoid foods high in potassium.
B. Take the medication with grapefruit juice.
C. Monitor blood pressure weekly.
D. Report any swelling of the lips or face.

Correct answer: D

Rationale: The correct instruction for a client prescribed losartan (Cozaar) is to report any swelling of the lips or face. Losartan can cause angioedema, which is a serious side effect that requires immediate medical attention. Clients do not need to avoid potassium-rich foods unless specifically instructed by their healthcare provider. Taking the medication with grapefruit juice is not recommended as it can interact with certain medications. Additionally, monitoring blood pressure regularly is important, but it should not be limited to a weekly basis; blood pressure should be monitored as per the healthcare provider's recommendation.

2. A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?

A. I need to watch for signs of infection.
B. I need to discontinue the medication after 14 days of use.
C. I can take the medication with meals to minimize nausea.
D. I need to call the health care provider (HCP) if more than one dose is missed.

Correct answer: B

Rationale: Azathioprine is an immunosuppressant taken for life. Discontinuing the medication after 14 days is incorrect.

3. A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?

A. Lung sounds
B. Blood pressure
C. Blood ammonia level
D. Serum potassium level

Correct answer: C

Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.

4. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select one that doesn't apply.

A. Diarrhea can occur secondary to the metformin.
B. The repaglinide is not taken if a meal is skipped.
C. The repaglinide is taken 30 minutes before eating.
D. Nausea and vomiting

Correct answer: D

Rationale: Repaglinide is a rapid-acting oral hypoglycemic that should be taken before meals and withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide, so carrying a simple sugar is essential. Metformin decreases hepatic glucose production and can cause diarrhea. Muscle pain may occur as an adverse effect and should be reported to the HCP.

5. A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus was previously well controlled with daily glyburide (DiaBeta). However, the fasting blood glucose level has recently been in the range of 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

A. Prednisone
B. Phenelzine (Nardil)
C. Atenolol (Tenormin)
D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone is known to reduce the effectiveness of oral hypoglycemic medications like glyburide and insulin, which can result in hyperglycemia. Therefore, the addition of prednisone to the client's regimen could have contributed to the elevated fasting blood glucose levels observed.