Nursing Elites

1. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: Corrected Question: When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor? Amitriptyline is known to cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down or sitting to a standing position. Monitoring for orthostatic hypotension is crucial to prevent falls and related injuries. Educating the client about moving slowly and changing positions gradually can help mitigate this adverse effect. Choices A, B, and C are incorrect because decreased appetite, explosive diarrhea, and decreased pulse rate are not commonly associated with Amitriptyline use. Therefore, the correct answer is D.

2. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Remove the nitroglycerin patch for 30 minutes if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each evening to prevent tolerance. This allows for a nitrate-free period of 10 to 12 hours during each 24-hour period, reducing the risk of developing tolerance to the medication. Choice B is incorrect because cutting the patch could alter the dose delivery and is not recommended. Choice C is incorrect as removing the patch for 30 minutes when a headache occurs may not be effective in managing symptoms. Choice D is incorrect as Nitroglycerin patches are usually applied once daily, not every 48 hours.

3. A client has a prescription for Nitroglycerin, and a nurse is providing teaching. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct instruction for taking Nitroglycerin is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. Option A is incorrect because taking a tablet every 15 minutes until pain is relieved may lead to delayed intervention. Option C is incorrect as taking Nitroglycerin at bedtime is not indicated for chest pain. Option D is incorrect as Nitroglycerin should be taken sublingually at the onset of chest pain, not on an empty stomach.

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

• A. Take this medication before meals.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that should be taken before meals to be most effective in reducing stomach acid production. Taking it before meals allows the medication to inhibit the proton pumps in the stomach when they are most active, leading to better control of acid secretion. Choice B is incorrect because taking Omeprazole with food may reduce its effectiveness as food can interfere with its absorption. Choice C is incorrect as Omeprazole is more effective when taken before meals. Choice D is incorrect as Omeprazole should not be taken with antacids as they can reduce its absorption.

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

• A. Take this medication with food.
• B. Monitor for signs of hyperglycemia.
• C. Avoid sudden discontinuation of the medication.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Metoprolol. Metoprolol is a beta-blocker that should be tapered off gradually to prevent rebound hypertension and other cardiac issues. Abruptly stopping Metoprolol can lead to serious complications, so it is essential for the client to follow the healthcare provider's guidance on discontinuation. Choice A is incorrect because Metoprolol can be taken with or without food. Choice B is incorrect as Metoprolol is not typically associated with causing hyperglycemia. Choice D is also incorrect as there is no need to increase potassium-rich foods specifically due to taking Metoprolol.

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