Nursing Elites

1. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is 'A: Somnolence.' Somnolence can indicate lactic acidosis, which is manifested by extreme drowsiness, hyperventilation, and muscle pain. It is a rare but very serious adverse effect caused by metformin and should be reported to the provider promptly to prevent further complications.

2. What is the therapeutic class of Valproate?

• A. Anticoagulant
• B. Antianxiety, benzodiazepines
• C. Anticonvulsant, vascular headache suppressant
• D. Mood stabilizer

Correct answer: C

Rationale: Valproate belongs to the therapeutic class of anticonvulsants. It is primarily used to manage seizures but is also effective in treating vascular headaches. Therefore, it is not classified as an anticoagulant, antianxiety medication, or mood stabilizer. Option A, anticoagulant, is incorrect as valproate does not have anticoagulant properties. Option B, antianxiety benzodiazepines, is incorrect as valproate is not primarily used to treat anxiety disorders with benzodiazepines. Option D, mood stabilizer, is incorrect as valproate is not classified as a mood stabilizer, although it can be used in some cases for mood disorders, its primary therapeutic class is anticonvulsant.

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

• A. Expect to feel drowsy.
• B. Increase your intake of high-potassium foods.
• C. Take the medication with grapefruit juice.
• D. Avoid foods high in fat.

Correct answer: A

Rationale: The correct answer is to expect to feel drowsy. Clonidine is known to cause drowsiness, especially at the beginning of treatment. It is important for clients to be cautious with activities that require alertness until they understand how the medication affects them. Choice B is incorrect as there is no specific need to increase high-potassium foods with Clonidine. Choice C is incorrect as grapefruit juice can interact with many medications but is not a typical instruction for Clonidine. Choice D is incorrect as there is no specific indication to avoid foods high in fat with Clonidine.

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

• A. Take this medication at bedtime.
• B. Avoid sudden discontinuation of the medication.
• C. Increase your intake of sodium-rich foods.
• D. Avoid drinking grapefruit juice.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Labetalol. Abrupt discontinuation of beta-blockers like Labetalol can lead to rebound hypertension and other cardiac issues. It is important for clients to taper off the medication under healthcare provider guidance to prevent potential complications.

5. A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bed.
• B. Monitor for increased blood pressure.
• C. Take the medication on an empty stomach.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.

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