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 hydrochlorothiazide. The client should monitor for which of the following adverse effects?

• A. Hyponatremia
• B. Ototoxicity
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: A

Rationale: Hyponatremia is a potential adverse effect of hydrochlorothiazide due to its diuretic action. Hydrochlorothiazide is a thiazide diuretic that can cause sodium and water loss, potentially leading to hyponatremia. Monitoring for symptoms such as weakness, confusion, and muscle cramps can help detect hyponatremia early. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) is not typically associated with hydrochlorothiazide use. Hyperkalemia (choice D) is more commonly associated with potassium-sparing diuretics rather than thiazide diuretics like hydrochlorothiazide.

3. A female client with tobacco use disorder is being educated by a nurse about Nicotine replacement therapy. Which of the following statements by the client shows understanding of the teaching?

• A. I should avoid eating right before I chew a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking if I become pregnant.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. The client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum. Choice B is incorrect because there is no specified timeline for stopping nicotine gum use. Choice C is incorrect because nicotine gum is not recommended during pregnancy. Choice D is incorrect as the client should chew the nicotine gum slowly for about 30 minutes, not quickly for 15 minutes.

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

• A. Expect a rapid heart rate.
• B. Take the medication with meals.
• C. Report any signs of restlessness or involuntary movements.
• D. Avoid consuming dairy products.

Correct answer: C

Rationale: The correct instruction to include when teaching a client about Metoclopramide is to report any signs of restlessness or involuntary movements. Metoclopramide can lead to extrapyramidal symptoms, such as restlessness or involuntary movements. It is essential for clients to notify their healthcare provider if they experience these symptoms to receive appropriate management.

5. A healthcare professional is educating a client about the adverse effects of Metformin. Which of the following adverse effects should the healthcare professional include?

• A. Lactic acidosis.
• B. Hypoglycemia.
• C. Hyperlipidemia.
• D. Weight gain.

Correct answer: A

Rationale: The correct answer is A: Lactic acidosis. Lactic acidosis is a rare but severe side effect of Metformin, particularly in individuals with renal or liver issues. It is crucial for clients taking Metformin to be aware of the symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, stomach discomfort, and feeling cold. Choice B, hypoglycemia, is not a common adverse effect of Metformin but can occur when combined with other antidiabetic medications. Choice C, hyperlipidemia, is not a typical adverse effect of Metformin. Choice D, weight gain, is not associated with Metformin use; in fact, Metformin is often associated with weight loss or weight neutrality.

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