Nursing Elites

1. When teaching a client who has a prescription for Lisinopril, which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Monitor for a persistent cough.
• C. Expect to have increased appetite.
• D. Avoid foods high in potassium.

Correct answer: B

Rationale: The correct answer is B: 'Monitor for a persistent cough.' Lisinopril, an ACE inhibitor, can cause a persistent dry cough as a side effect. It is essential for the client to report this symptom to their healthcare provider for further evaluation and management. Choice A is incorrect because Lisinopril is typically taken in the morning. Choice C is incorrect as Lisinopril is not known to cause increased appetite. Choice D is also incorrect as Lisinopril can lead to increased potassium levels in the blood, so avoiding foods high in potassium is not necessary.

2. A client informs a healthcare professional about taking Gingko Biloba. Which of the following medications is contraindicated for a client using Gingko Biloba?

• A. Acetaminophen
• B. Warfarin
• C. Digoxin
• D. Lisinopril

Correct answer: B

Rationale: Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction that can lead to suppressed coagulation and an increased risk of bleeding or hemorrhage. Warfarin is an anticoagulant, and when combined with Gingko Biloba, which also has anticoagulant properties, the risk of bleeding complications is significantly heightened. Acetaminophen (Choice A), Digoxin (Choice C), and Lisinopril (Choice D) do not have significant interactions with Gingko Biloba compared to Warfarin. Acetaminophen is a pain reliever, Digoxin is a medication for heart conditions, and Lisinopril is an ACE inhibitor for hypertension.

3. The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching?

• A. Decrease salt and fat intake and limit alcohol intake.
• B. There are no dietary restrictions for a person diagnosed with angina.
• C. Limit smoking and increase protein and sugar intake.
• D. Increase fruits, vegetables, and foods high in cholesterol.

Correct answer: A

Rationale: The correct answer is to decrease salt and fat intake and limit alcohol intake. These dietary changes can help manage angina by reducing the workload on the heart and preventing further plaque buildup in the arteries. Choices B, C, and D are incorrect as dietary restrictions for angina typically involve reducing salt, fat, and alcohol intake, rather than increasing sugar or cholesterol intake.

4. When starting amitriptyline, a client should be instructed to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Urinary retention
• C. Bradycardia
• D. Dry cough

Correct answer: B

Rationale: When a client starts taking amitriptyline, an important adverse effect to monitor for is urinary retention. Amitriptyline is a tricyclic antidepressant that can cause anticholinergic effects, including urinary retention. It is crucial to educate the client on recognizing and reporting this adverse effect to their healthcare provider. Diarrhea is not a common adverse effect of amitriptyline and is more associated with other medications. Bradycardia is a possible adverse effect of amitriptyline, but urinary retention is a more common and significant concern. Dry cough is not a typical adverse effect of amitriptyline.

5. A client is receiving discharge instructions for a new prescription of Enoxaparin. Which of the following instructions should the provider include?

• A. Inject the medication into the muscle.
• B. Massage the injection site after administration.
• C. Rotate injection sites between the arms and thighs.
• D. Administer the medication in the abdomen.

Correct answer: D

Rationale: The correct answer is to administer the medication in the abdomen. Enoxaparin is administered as a subcutaneous injection in the abdomen to prevent bleeding complications. Injecting into the muscle or massaging the site can increase the risk of bleeding. Rotating sites between the arms and thighs is not recommended for Enoxaparin administration due to variations in absorption rates. Therefore, the provider should instruct the client to administer Enoxaparin in the abdomen for optimal effectiveness and safety.

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