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A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take one tablet at the first sign of chest pain.
- B. If pain is not relieved, take another tablet in 10 minutes.
- C. You can take up to five tablets in 15 minutes.
- D. Swallow the tablet with water.
Correct Answer: A
Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.
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A client has a new prescription for Verapamil to treat angina. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of Verapamil?
- A. I am frequently constipated.
- B. I have been urinating more frequently.
- C. My skin is peeling.
- D. I have ringing in my ears.
Correct Answer: A
Rationale: The correct answer is A: 'I am frequently constipated.' Constipation is a common adverse effect of Verapamil, a calcium channel blocker. Verapamil can slow down intestinal motility, leading to constipation as a side effect. Choices B, C, and D are not typically associated with adverse effects of Verapamil. Increased urination is not a common side effect, skin peeling is not related to Verapamil use, and ringing in the ears is not a typical adverse effect of this medication.
A client has a new prescription for Clopidogrel. Which of the following instructions should the nurse include?
- A. Take this medication with food.
- B. Avoid taking aspirin while on this medication.
- C. Avoid eating foods high in potassium.
- D. Take this medication at bedtime.
Correct Answer: B
Rationale: When a client is prescribed Clopidogrel, an antiplatelet medication, the nurse should instruct them to avoid taking aspirin or other NSAIDs. This is because both medications can increase the risk of bleeding when taken together, potentially leading to serious health complications. Therefore, it is crucial for the client to follow this instruction to ensure their safety and well-being while on Clopidogrel. Choices A, C, and D are incorrect because taking Clopidogrel with food, avoiding foods high in potassium, or taking the medication at bedtime are not specific instructions related to the safe use of Clopidogrel and do not address the potential interaction with aspirin, which is essential for the client's well-being.
A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?
- A. A client with a history of deep-vein thrombosis
- B. A client with a history of migraine headaches
- C. A client with a history of hypertension
- D. A client with a history of anemia
Correct Answer: A
Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots forming and leading to serious complications like pulmonary embolism. Clients with a history of deep-vein thrombosis are at a higher risk of recurrent thromboembolic events when taking tamoxifen, making it unsafe for such individuals. Choices B, C, and D are not contraindications for tamoxifen therapy, as migraine headaches, hypertension, and anemia do not directly interact with tamoxifen's mechanism of action or pose significant risks when used together.
A client is being discharged with a new prescription for Clopidogrel. Which of the following instructions should the nurse include?
- A. Avoid taking aspirin while on this medication.
- B. Take this medication with food.
- C. Avoid eating foods high in potassium.
- D. Take this medication at bedtime.
Correct Answer: A
Rationale: The correct instruction for a client prescribed Clopidogrel is to avoid taking aspirin while on this medication. Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs can potentiate the risk of bleeding, so they should be avoided while taking Clopidogrel to prevent adverse effects. Choices B, C, and D are incorrect because Clopidogrel does not need to be taken with food, there is no specific dietary restriction related to potassium, and the timing of administration (bedtime) is not a critical instruction for this medication.
A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?
- A. Varicella vaccine
- B. Rubella vaccine
- C. Inactivated influenza vaccine
- D. Measles vaccine
Correct Answer: C
Rationale: During pregnancy, it is safe for women to receive the inactivated influenza vaccine, which is recommended by healthcare providers to protect pregnant individuals from influenza. Vaccination with inactivated influenza vaccine during pregnancy not only provides protection to the pregnant individual but also confers passive immunity to the newborn during the vulnerable early months of life. The Varicella, Rubella, and Measles vaccines are live vaccines and are contraindicated during pregnancy due to the theoretical risk of transmission of the live virus to the fetus, which could potentially cause harm.