Nursing Elites

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

• A. Take the medication with food.
• B. Expect red-orange discoloration of body fluids.
• C. Monitor for signs of hyperglycemia.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is to inform the client to expect red-orange discoloration of body fluids when taking rifampin. Rifampin is known to cause this side effect, which is harmless but can be surprising to patients. It is important for the nurse to educate the client about this expected change to prevent unnecessary concern or alarm. Monitoring for hyperglycemia is not directly related to rifampin, and taking the medication with food or avoiding dairy products are not specific instructions for this medication.

2. A client with peripheral arterial disease complains of leg pain while walking. The nurse should reinforce which teaching point with the client?

• A. Wear compression stockings daily.
• B. Increase daily walking distance gradually.
• C. Elevate legs above heart level when resting.
• D. Use a heating pad to soothe leg muscles.

Correct answer: B

Rationale: For clients with peripheral arterial disease experiencing leg pain while walking, the priority teaching point is to gradually increase daily walking distance. This approach helps improve circulation, build tolerance, and reduce symptoms over time. While compression stockings can be beneficial for circulation, they are not the priority teaching point in this scenario. Elevating legs above heart level when resting is more appropriate for clients with venous insufficiency, not peripheral arterial disease. Using a heating pad is not recommended as it can potentially cause burns or skin damage in clients with compromised circulation.

3. Why should the client diagnosed with rheumatic heart disease be advised to notify the dentist before dental procedures?

• A. The client requires prophylactic antibiotics before treatment.
• B. The client may experience dysrhythmias with high-speed drills.
• C. The client may have an adverse reaction to lidocaine with epinephrine.
• D. The client may develop heart failure during stressful events.

Correct answer: A

Rationale: Clients with rheumatic heart disease are at risk for infective endocarditis, a serious infection of the heart lining or valves. They need prophylactic antibiotics before invasive procedures, including dental work, to prevent this life-threatening complication. While dysrhythmias with high-speed drills, adverse reactions to local anesthesia, and the risk of heart failure during stressful events are all concerns for clients with heart conditions, the primary reason for notifying the dentist before dental procedures in rheumatic heart disease is the need for prophylactic antibiotics to prevent infective endocarditis.

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

• A. Take the medication with food.
• B. Monitor for signs of hypoglycemia.
• C. Increase fluid intake.
• D. Expect a metallic taste in the mouth.

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration can also help reduce the risk of kidney problems associated with metformin use. Choices A, B, and D are incorrect. While it's generally recommended to take metformin with food to reduce stomach upset, monitoring for signs of hypoglycemia is more relevant for other antidiabetic medications, and a metallic taste in the mouth is not a common side effect of metformin.

5. A client diagnosed with hypertension is prescribed atenolol (Tenormin). The nurse should monitor the client for which common side effect of this medication?

• A. Tachycardia
• B. Dry mouth
• C. Hypotension
• D. Increased appetite

Correct answer: C

Rationale: Atenolol is a beta-blocker that works by lowering blood pressure. A common side effect of atenolol is hypotension, where blood pressure drops too low. Therefore, the nurse should monitor the client for signs and symptoms of hypotension to prevent any complications. Choices A, B, and D are incorrect because tachycardia (fast heart rate), dry mouth, and increased appetite are not common side effects of atenolol. Hypotension is the expected side effect due to the medication's mechanism of action.

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