Nursing Elites

1. A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse include in the teaching plan?

• A. Take the medication with meals.
• B. Monitor for signs of hypoglycemia.
• C. Avoid alcohol while taking this medication.
• D. Take the medication at bedtime.

Correct answer: C

Rationale: Clients taking metformin (Glucophage) should avoid alcohol as it can increase the risk of lactic acidosis. Metformin should be taken with meals to reduce gastrointestinal upset. While hypoglycemia is less common with metformin compared to other diabetes medications, clients should still be aware of its symptoms.

2. A healthcare provider is preparing to administer a prescribed dose of digoxin (Lanoxin) to a client. Before administering the medication, the healthcare provider should:

• A. Measure the client's blood pressure.
• B. Check the client's heart rate.
• C. Assess the client's respiratory rate.
• D. Check the client's oxygen saturation level.

Correct answer: B

Rationale: Before administering digoxin (Lanoxin), the healthcare provider should check the client's heart rate. Monitoring the heart rate is crucial because if it is below 60 beats per minute, the medication should be withheld, and the healthcare provider must be informed. While blood pressure, respiratory rate, and oxygen saturation are essential assessments, they are not the primary focus before administering digoxin.

3. A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:

• A. Drink at least 2 L of fluid per day.
• B. Take the daily dose at bedtime.
• C. Avoid changing brands of the medication without health care provider (HCP) approval.
• D. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP.

Correct answer: B

Rationale: The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.

4. A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?

• A. I will avoid potassium-rich foods.
• B. I will not use a salt substitute.
• C. I will monitor my weight daily.
• D. I will increase my fluid intake as prescribed.

Correct answer: A

Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.

5. A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:

• A. Telling the client not to take the medication with food
• B. Suggesting that the client taper the dose until taste returns to normal
• C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
• D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor

Correct answer: C

Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.

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