Nokea
A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?
- A. Stop taking the medication if your heart rate is below 70/min.
- B. Take the medication with food.
- C. Avoid sudden changes in position.
- D. Increase your fluid intake while taking this medication.
Correct Answer: C
Rationale: The correct instruction for a client starting Metoprolol is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, leading to dizziness and falls if the client changes positions quickly. By advising the client to make position changes slowly, the nurse helps prevent these adverse effects and promotes safety.
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A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into the skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct Answer: A
Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.
During an admission assessment for a client with severe Aspirin toxicity, which finding should the nurse expect?
- A. Body temperature 35°C (95°F)
- B. Lung crackles
- C. Cool, dry skin
- D. Respiratory depression
Correct Answer: D
Rationale: In severe Aspirin toxicity, respiratory depression is an anticipated finding due to the development of respiratory acidosis. Aspirin toxicity can lead to metabolic acidosis, causing the individual to hyperventilate initially to compensate. However, as the condition progresses, respiratory depression can occur, resulting in impaired gas exchange and respiratory acidosis.
When teaching a client with a new prescription for Ramelteon, which of the following foods should the nurse instruct the client to avoid?
- A. Baked potato
- B. Fried chicken
- C. Whole-grain bread
- D. Citrus fruits
Correct Answer: B
Rationale: The correct answer is B: Fried chicken. High-fat foods, like fried chicken, can delay the absorption of Ramelteon. It is important for the client to avoid such foods to ensure the medication's effectiveness. Baked potato, whole-grain bread, and citrus fruits do not have a significant interaction with Ramelteon and can be consumed safely while taking the medication.
A client has a new prescription for Lisinopril. Which of the following instructions should the nurse include?
- A. Avoid salt substitutes.
- B. Take this medication at bedtime.
- C. Increase your intake of potassium-rich foods.
- D. Take this medication with food.
Correct Answer: A
Rationale: The correct instruction for a client prescribed Lisinopril is to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, hence the importance of avoiding salt substitutes that may contain potassium. Instructing the client to avoid salt substitutes helps prevent potential adverse effects of increased potassium levels.
A client with angina is seeking a prescription for sildenafil to manage erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?
- A. Aspirin
- B. Isosorbide
- C. Clopidogrel
- D. Atorvastatin
Correct Answer: B
Rationale: Isosorbide, an organic nitrate used for angina, is contraindicated with sildenafil due to the risk of fatal hypotension. Concurrent use of these medications can lead to severe hypotension. Patients are advised to avoid taking nitrate medications for 24 hours after using isosorbide to prevent this dangerous interaction.