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. Before administering lithium to a client with bipolar disorder who has been taking the medication for 1 year, the nurse should check to see that which of the following tests has been completed?

• A. Thyroid hormone assay
• B. Liver function tests
• C. Erythrocyte sedimentation rate
• D. Brain natriuretic peptide

Correct answer: A

Rationale: The correct answer is to check the thyroid hormone assay. Long-term lithium use can result in thyroid dysfunction, making it crucial to monitor the client's thyroid function regularly to detect any abnormalities early and prevent potential complications. Liver function tests (choice B) are not specifically associated with lithium therapy. Erythrocyte sedimentation rate (choice C) is a nonspecific test for inflammation and not directly related to lithium therapy. Brain natriuretic peptide (choice D) is a test used to diagnose heart failure and is not relevant to monitoring lithium therapy.

3. A client is reviewing a new prescription for Terbutaline with a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

• A. I can increase my activity now that I've started on this medication.
• B. I will increase my daily fluid intake to 3 quarts.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider as these are signs of preterm labor. Monitoring contractions is crucial for the management of preterm labor and the safety of both the client and the fetus. Choices A, B, and D are incorrect because increasing activity, fluid intake, or assuming the medication will prevent preterm labor do not address the essential need to report changes in contractions, which are a vital sign of potential complications in preterm labor.

4. A client is being discharged and will start long-term oral prednisone for chronic asthma treatment. The client should monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: Weight gain is an adverse effect of oral prednisone due to sodium and water retention, which leads to fluid retention. This can be monitored by tracking weight changes. Nervousness (Choice B) is not a common adverse effect of prednisone. Bradycardia (Choice C) is not typically associated with prednisone use; in fact, tachycardia can be more common. Constipation (Choice D) is not a prominent adverse effect of prednisone.

5. When starting a new prescription for prednisone, which instruction should the nurse include for the client?

• A. Increase your intake of potassium-rich foods.
• B. Do not stop taking this medication abruptly.
• C. Avoid grapefruit juice while taking this medication.
• D. Take the medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for a client starting a new prescription for prednisone is not to stop taking the medication abruptly. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, emphasizing the importance of gradual tapering under healthcare provider guidance. Increasing potassium-rich foods may be necessary based on individual needs, but it is not the priority instruction in this context. Grapefruit juice interaction is more commonly associated with certain medications but not specifically with prednisone. Taking prednisone at bedtime to prevent drowsiness is not a key instruction related to its administration.

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