Nursing Elites

1. A client is receiving discharge teaching for a new prescription of Fluoxetine for PTSD. Which of the following statements should be included in the teaching?

• A. You may experience a decreased desire for intimacy while taking this medication.
• B. You should take this medication in the evening to help promote sleep.
• C. You may experience fewer urinary adverse effects if you urinate just before taking this medication.
• D. You should wear sunglasses when outdoors due to the light sensitivity caused by this medication.

Correct answer: A

Rationale: One of the potential adverse effects of fluoxetine and other SSRIs is a decreased libido, which can impact intimacy. It is essential for the nurse to educate the client about this possible side effect to promote awareness and understanding of the medication's effects.

2. When educating a client who has a prescription for Propranolol, what instruction should the healthcare provider include?

• A. Take this medication with food.
• B. Discontinue the medication if you feel fatigued.
• C. Expect to have decreased heart rate with this medication.
• D. Do not stop taking this medication abruptly.

Correct answer: D

Rationale: The correct instruction for a client with a prescription for Propranolol is not to stop taking the medication abruptly. Abrupt cessation can result in rebound hypertension or other cardiac complications. It is crucial for the client to taper off the medication gradually under healthcare provider supervision to prevent adverse effects. Choice A is incorrect because Propranolol can be taken with or without food. Choice B is incorrect as discontinuing the medication based on fatigue alone is not advisable without consulting a healthcare provider. Choice C is incorrect because while Propranolol can decrease heart rate, it is not the primary instruction to provide in this scenario.

3. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of the medication. Dietary fiber can help maintain bowel regularity and alleviate constipation.

4. When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?

• A. “Your chest pain should go away with one tablet.”
• B. “If your chest pain doesn’t go away after three tablets, call 911; you might be having a heart attack.”
• C. “If your chest pain doesn’t go away with one tablet, you can repeat the dose as many times as you need to.”
• D. “Be sure to call 911 before you take any tablets.”

Correct answer: B

Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.

5. When administering digoxin (Lanoxin) to a patient, the healthcare provider observes various signs and symptoms of an overdose. Which of the following should the healthcare provider give to reverse digoxin toxicity?

• A. Naloxone
• B. Vitamin K
• C. Digibind
• D. Flumazenil

Correct answer: C

Rationale: Digibind, also known as Digoxin immune Fab, is the specific antidote used to treat digoxin toxicity. It works by binding to digoxin in the body, forming a complex that can be excreted by the kidneys, thereby reversing the toxic effects of digoxin overdose. Naloxone is used for opioid overdoses, not digoxin toxicity. Vitamin K is used to reverse the effects of warfarin overdose. Flumazenil is used to reverse the effects of benzodiazepine overdose, not digoxin toxicity.

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