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A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?
- A. I will take one tablet every 5 minutes, up to three tablets.
- B. I should take one tablet at the onset of angina and stop activity.
- C. I need to replace nitroglycerin tablets every 3 to 6 months to maintain freshness.
- D. I should ensure that I chew the pill completely before swallowing it.
Correct Answer: D
Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.
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A client with a diagnosis of generalized anxiety disorder is prescribed hydroxyzine. The nurse should instruct the client that this medication may have which potential side effect?
- A. Drowsiness
- B. Dry mouth
- C. Nausea
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Drowsiness. Hydroxyzine is known to cause drowsiness, so clients should be advised to avoid activities like driving until they understand how the medication affects them. Choices B, C, and D are incorrect because dry mouth, nausea, and headache are not commonly associated with hydroxyzine use. It is crucial for the client to be aware of the potential drowsiness to ensure their safety and well-being while taking this medication.
A client with hypertension is prescribed valsartan. The nurse should monitor the client for which potential side effect?
- A. Hypotension
- B. Tachycardia
- C. Hyperglycemia
- D. Hyponatremia
Correct Answer: A
Rationale: The correct answer is A: Hypotension. Valsartan is an angiotensin II receptor blocker that can cause hypotension as a side effect by dilating blood vessels. Monitoring blood pressure is crucial to prevent complications related to low blood pressure. Choice B, Tachycardia, is incorrect because valsartan typically does not cause an increase in heart rate. Choice C, Hyperglycemia, is not a common side effect of valsartan. Choice D, Hyponatremia, is also unlikely with valsartan use.
A client with diabetes mellitus type 2 is prescribed metformin. What instruction should the nurse include in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid alcohol while taking this medication.
- C. Take this medication on an empty stomach.
- D. Report any signs of lactic acidosis to the healthcare provider.
Correct Answer: A
Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals. Taking metformin with meals helps to minimize gastrointestinal side effects, which are common with this medication. Choice B, avoiding alcohol, is a good practice due to the increased risk of lactic acidosis when alcohol is consumed with metformin; however, it is not the priority teaching point in this scenario. Taking metformin on an empty stomach (Choice C) is incorrect because it can increase the risk of gastrointestinal side effects. Reporting signs of lactic acidosis (Choice D) is important, but it is more related to monitoring for adverse effects rather than a primary teaching point for administration.
A client vomits 30 minutes after receiving a dose of hydromorphone on the first postoperative day. What initial intervention is best for the practical nurse (PN) to implement?
- A. Obtain a prescription for nasogastric intubation.
- B. Administer a prn dose of ondansetron.
- C. Reduce the next scheduled dose of hydromorphone.
- D. Assess the client's abdomen and bowel sounds.
Correct Answer: B
Rationale: In this scenario, the client's vomiting is likely due to the hydromorphone administration, indicating a need for an antiemetic such as ondansetron to address the nausea. Nasogastric intubation (Choice A) is not necessary at this point as the client is vomiting, not experiencing an obstruction. While reducing the dose of hydromorphone (Choice C) may be considered later, the immediate focus should be managing the client's symptoms. Assessing the client's abdomen and bowel sounds (Choice D) can be important but is not the initial priority when addressing the vomiting post hydromorphone administration.
A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?
- A. Wort can decrease plasma concentration of Cyclospora
- B. Wort can decrease plasma concentration of Tacrolimus
- C. Wort can decrease plasma concentration of Cyclosporine
- D. Wort can decrease plasma concentration of Mycophenolate
Correct Answer: C
Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.