Nursing Elites

1. A client has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a non-hairy area.
• B. Change the patch every 72 hours.
• C. Avoid exposure to heat sources.
• D. Do not cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction the nurse should include for a client using a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, potentially causing an overdose. Instructing the client to avoid heat sources is crucial to ensure their safety and the effectiveness of the medication. Choices A, B, and D are incorrect because applying the patch to a non-hairy area, changing it every 72 hours, and not cutting the patch are general guidelines for using transdermal patches but do not specifically address the unique risks associated with Fentanyl patches.

2. A client has a new prescription for Alendronate. Which of the following instructions should be included in the discharge teaching?

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. This medication can cause esophageal irritation, and maintaining an upright position for at least 30 minutes helps prevent complications such as esophagitis or esophageal ulcers. Choice A is incorrect because Alendronate should be taken in the morning on an empty stomach. Choice C is incorrect because Alendronate should be taken on an empty stomach, preferably 30 minutes before the first food, beverage, or medication of the day. Choice D is incorrect because while calcium intake is important, it is not a specific instruction related to taking Alendronate.

3. A client is being discharged with a new prescription for Clopidogrel. Which of the following instructions should the nurse include?

• A. Avoid taking aspirin while on this medication.
• B. Take this medication with food.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed Clopidogrel is to avoid taking aspirin while on this medication. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs can potentiate the risk of bleeding, so they should be avoided while taking Clopidogrel to prevent adverse effects. Choices B, C, and D are incorrect because Clopidogrel does not need to be taken with food, there is no specific dietary restriction related to potassium, and the timing of administration (bedtime) is not a critical instruction for this medication.

4. When educating a client with early Parkinson's disease about pramipexole, what adverse effect should the nurse advise the client to monitor for?

• A. Hallucinations
• B. Increased salivation
• C. Diarrhea
• D. Discoloration of urine

Correct answer: A

Rationale: The correct answer is A: Hallucinations. Pramipexole can lead to hallucinations, especially within 9 months of starting the medication, and may necessitate discontinuation. Hallucinations are a serious adverse effect that the client should be aware of and report promptly to their healthcare provider for evaluation and management. Increased salivation (choice B), diarrhea (choice C), and discoloration of urine (choice D) are not common adverse effects associated with pramipexole and are not typically emphasized in client education for this medication.

5. During an assessment, a male client who has recently started taking Haloperidol is displaying certain symptoms. Which of the following findings should the nurse prioritize in reporting to the provider?

• A. Shuffling gait
• B. Neck spasms
• C. Drowsiness
• D. Impotence

Correct answer: B

Rationale: Neck spasms are indicative of acute dystonia, a serious side effect of Haloperidol that requires urgent intervention. Immediate reporting to the provider is crucial to address this potentially harmful condition and ensure the client's safety. Shuffling gait, drowsiness, and impotence are important to monitor but do not pose the same level of immediate risk as acute dystonia. Acute dystonia can lead to serious complications if not promptly treated, making it the priority in this scenario.

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