Nursing Elites

1. A client has a new prescription for Amlodipine. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication at bedtime.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of high-sodium foods.
• D. Expect a dry cough.

Correct answer: B

Rationale: The correct instruction for the nurse to include during discharge teaching is to advise the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of amlodipine, a calcium channel blocker, leading to increased drug levels in the blood. This can result in potentiated side effects and potential toxicity. Option A is incorrect as amlodipine is usually taken once daily, not specifically at bedtime. Option C is incorrect because high-sodium foods are generally discouraged in individuals with hypertension. Option D is incorrect as a dry cough is not an expected side effect of amlodipine.

2. A healthcare provider is assessing a client who is taking Digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?

• A. Bruising
• B. Report of metallic taste
• C. Muscle pain
• D. Report of anorexia

Correct answer: D

Rationale: The correct manifestation of digoxin toxicity is the report of anorexia. Anorexia, blurred vision, stomach pain, and diarrhea are common signs of digoxin toxicity. Bruising, metallic taste, and muscle pain are not typically associated with digoxin toxicity. Patients should promptly report symptoms of toxicity to their healthcare provider for further evaluation and management.

3. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

4. A client is prescribed an IM dose of penicillin. The client reports developing a rash after taking penicillin 3 years ago. What should the nurse do?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The nurse should withhold the medication and inform the provider of the client's previous rash after taking penicillin. This history suggests a potential allergic reaction to penicillin, which can range from mild to severe anaphylaxis. Notifying the provider allows for an alternative antibiotic to be prescribed, considering the client's allergy to penicillin. It is crucial to avoid administering a medication that could potentially lead to a severe allergic reaction in the client. Administering the prescribed dose (Choice A) could be harmful due to the potential for an allergic reaction. Changing the prescription to an oral form (Choice C) does not address the underlying issue of a potential penicillin allergy. Administering an oral antihistamine (Choice D) without consulting the provider may not be sufficient to prevent a severe allergic reaction.

5. A client has a new prescription for Amlodipine. Which of the following side effects should the client monitor for and report?

• A. Swelling of the ankles.
• B. Increased urination.
• C. Persistent cough.
• D. Dark-colored urine.

Correct answer: A

Rationale: Corrected Rationale: Amlodipine, a calcium channel blocker, can cause peripheral edema (swelling of the ankles) as a side effect. This occurs due to the dilation of blood vessels and increased fluid retention. It is important for the client to monitor for ankle swelling as it could indicate a potential adverse reaction to the medication. Reporting this side effect to the healthcare provider is crucial to ensure appropriate management and potential adjustment of the treatment plan.\n Choice B, increased urination, is not a common side effect of Amlodipine. Choice C, persistent cough, is more commonly associated with ACE inhibitors rather than calcium channel blockers like Amlodipine. Choice D, dark-colored urine, is not a typical side effect of Amlodipine and is not something the client should specifically monitor for and report while taking this medication.

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