Nursing Elites

1. A client has a new prescription for metformin. Which of the following statements should the nurse include in the teaching?

• A. Take the medication with a full glass of water.
• B. Monitor for signs of hypoglycemia.
• C. Increase your fluid intake.
• D. Expect a metallic taste in your mouth.

Correct answer: C

Rationale: Increasing fluid intake is an important teaching point for clients starting metformin to prevent gastrointestinal discomfort, a common side effect of this medication. Metformin can cause gastrointestinal symptoms such as nausea, bloating, and diarrhea, which can be reduced by staying well-hydrated. Therefore, advising the client to increase their fluid intake will help minimize these side effects and improve medication tolerance. The other options are incorrect: Option A is a general instruction for taking medications but not specifically related to metformin. Option B is incorrect because metformin typically does not cause hypoglycemia but rather hyperglycemia. Option D is also incorrect as a metallic taste in the mouth is not a common side effect of metformin.

2. The LPN/LVN is reinforcing discharge instructions to a client who has been prescribed nitroglycerin sublingual tablets for angina. Which statement by the client indicates a need for further teaching?

• A. I will keep my nitroglycerin tablets in the original glass bottle.
• B. I will sit or lie down when I take a nitroglycerin tablet.
• C. I will take a nitroglycerin tablet every 5 minutes if chest pain persists, up to a total of 3 tablets.
• D. I can swallow the nitroglycerin tablet with a glass of water if it does not dissolve quickly.

Correct answer: D

Rationale: The correct answer is D. Nitroglycerin sublingual tablets should not be swallowed; they must dissolve under the tongue to be effective. Choice A is correct as nitroglycerin tablets should be stored in their original glass container to prevent degradation. Choice B is correct as sitting or lying down when taking a nitroglycerin tablet helps prevent dizziness or fainting due to a sudden drop in blood pressure. Choice C is correct as taking a nitroglycerin tablet every 5 minutes for a maximum of 3 tablets is the correct protocol for managing angina symptoms.

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

• A. You should have your white blood cell count checked regularly.
• B. You should take this medication on an empty stomach.
• C. You should avoid eating foods high in tyramine.
• D. You should avoid taking this medication with milk.

Correct answer: A

Rationale: The correct answer is A: 'You should have your white blood cell count checked regularly.' Clozapine can lead to agranulocytosis, a serious condition characterized by a low white blood cell count. Regular monitoring of the white blood cell count is crucial to detect this adverse effect early and prevent serious complications. Choices B, C, and D are incorrect because taking clozapine on an empty stomach, avoiding foods high in tyramine, or avoiding taking the medication with milk are not specific instructions related to the potential adverse effect of agranulocytosis associated with clozapine.

4. A client has a new prescription for lisinopril. Which of the following findings should be reported to the provider by the nurse?

• A. Weight gain
• B. Dry cough
• C. Hypokalemia
• D. Increased appetite

Correct answer: B

Rationale: The correct answer is B - Dry cough. Lisinopril is known to cause a persistent dry cough as a common side effect. This adverse reaction can be bothersome to the client and may necessitate discontinuation of the medication. Weight gain, hypokalemia, and increased appetite are not typically associated with lisinopril and would not be as concerning as a dry cough when assessing for adverse effects.

5. A healthcare provider is reviewing the medication administration record of a client who has a latex allergy. Which of the following medications should the healthcare provider identify as a potential risk for an allergic reaction?

• A. Cefoxitin
• B. Amoxicillin
• C. Erythromycin
• D. Metronidazole

Correct answer: A

Rationale: The correct answer is A, Cefoxitin. Cefoxitin can contain latex in the stopper of the vial, which may pose a risk for allergic reaction in individuals with latex sensitivity. Amoxicillin, Erythromycin, and Metronidazole do not typically contain latex components in their formulations. Healthcare providers should be vigilant in identifying and avoiding medications with latex components to prevent adverse reactions in patients with known latex allergies.

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