Nursing Elites

1. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Remove the nitroglycerin patch for 30 minutes if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each evening to prevent tolerance. This allows for a nitrate-free period of 10 to 12 hours during each 24-hour period, reducing the risk of developing tolerance to the medication. Choice B is incorrect because cutting the patch could alter the dose delivery and is not recommended. Choice C is incorrect as removing the patch for 30 minutes when a headache occurs may not be effective in managing symptoms. Choice D is incorrect as Nitroglycerin patches are usually applied once daily, not every 48 hours.

2. A client has been prescribed Prednisone for an inflammatory condition and is receiving discharge teaching from a nurse. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Avoid alcohol while taking this medication.
• C. Monitor your blood pressure regularly.
• D. Take this medication in the morning to prevent insomnia.

Correct answer: D

Rationale: The correct answer is to take Prednisone in the morning to prevent insomnia. Prednisone can cause insomnia as a side effect, so taking it in the morning can help minimize this issue. It is important to follow the healthcare provider's instructions regarding the timing of Prednisone administration to optimize its effectiveness and minimize adverse effects.

3. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.

4. A healthcare provider is teaching the parents of a school-age child about transdermal Methylphenidate. Which of the following instructions should the healthcare provider include?

• A. Apply one patch twice a day.
• B. Leave the patch on for 9 hours.
• C. Apply the patch to the child's waist.
• D. Use the opened tray within 6 months.

Correct answer: B

Rationale: When administering transdermal Methylphenidate, it is important to leave the patch on for 9 hours each day to ensure the medication is effective. This duration allows for proper absorption of the medication through the skin. It is crucial for parents to follow this instruction to achieve the desired therapeutic effect for their child.

5. While providing teaching to a client with a new prescription for Enalapril, the nurse should instruct the client to report which of the following manifestations as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: The correct answer is 'B: Dry cough.' Enalapril is an ACE inhibitor known to cause a persistent dry cough as a common adverse effect. This cough should be reported to the healthcare provider for further evaluation, as it may indicate a potential issue with the medication that needs attention to ensure the client's well-being. Tremors (Choice A), drowsiness (Choice C), and hyperactivity (Choice D) are not typically associated with Enalapril use. Therefore, they are incorrect choices for this question.

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