Nursing Elites

1. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include in the discharge teaching?

• 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 Nitroglycerin sublingual tablets is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. This regimen helps in relieving angina symptoms effectively. Option A of taking one tablet every 15 minutes is too infrequent and may delay symptom relief. Option C of taking one tablet at bedtime is not appropriate as Nitroglycerin is used for immediate relief of angina. Option D of taking one tablet on an empty stomach is irrelevant since Nitroglycerin is not affected by food intake.

2. A client is being educated by a healthcare provider about Terbutaline. Which of the following statements by the client indicates understanding of the teaching?

• A. This medication will stop my contractions.
• B. This medication will prevent vaginal bleeding.
• C. This medication will promote blood flow to my baby.
• D. This medication will increase my prostaglandin production.

Correct answer: A

Rationale: The correct answer is A. Terbutaline works by blocking beta2-adrenergic receptors, leading to uterine smooth muscle relaxation and stopping contractions. It is commonly used to delay preterm labor. Choice B is incorrect because Terbutaline is not used to prevent vaginal bleeding. Choice C is incorrect because Terbutaline's primary action is not related to promoting blood flow to the baby. Choice D is incorrect because Terbutaline does not increase prostaglandin production; instead, it works by blocking beta2-adrenergic receptors.

3. A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication with your first bite of food.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication with your first bite of food.' Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. By taking the medication with the first bite of food, the client can help minimize potential stomach upset and improve the drug's effectiveness. Choice B is incorrect because taking Metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect as there is no specific recommendation to take Metformin before bedtime. Choice D is incorrect because Metformin is typically taken daily, not every other day, as prescribed by the healthcare provider.

4. A client has a new prescription for Methotrexate. Which of the following instructions should be included in the teaching?

• A. Avoid drinking alcohol while taking this medication.
• B. Take the medication with a high-fat meal.
• C. Expect increased hair growth.
• D. You should never stop taking the medication without consulting your healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client taking Methotrexate is to avoid drinking alcohol. Methotrexate can cause liver toxicity, and alcohol consumption can increase this risk. It is important to emphasize the avoidance of alcohol while on this medication to prevent adverse effects and ensure treatment effectiveness. The other options are incorrect: Taking Methotrexate with a high-fat meal is not necessary as it can be taken with or without food. Increased hair growth is not an expected effect of Methotrexate; in fact, hair loss is a potential side effect. Stopping the medication without consulting a healthcare provider can be dangerous and may lead to worsening of symptoms or relapse, making option D incorrect.

5. A client has a new prescription for Atenolol. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B. Atenolol is a beta-blocker that can cause bradycardia, leading to a decreased heart rate. Monitoring heart rate regularly is essential to detect any significant decreases promptly and seek medical attention. While choices A, C, and D may be relevant to the client's overall health, monitoring heart rate is the priority instruction due to the nature of Atenolol's effects. Taking the medication in the morning can be individualized based on the client's needs and preferences. Avoiding foods high in potassium and increasing fluid intake are generally beneficial but not directly related to managing the side effects of Atenolol.

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