Nokea
A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in the client education related to this medication?
- A. This medication is prescribed for long-term therapy prophylaxis against anginal attacks
- B. Do not crush this medication
- C. Take the medication in the evening after dinner
- D. Do not take an additional tablet if you experience chest pain
Correct Answer: A
Rationale: The correct answer is A because isosorbide mononitrate is used for long-term prophylaxis against anginal attacks. Choice B is incorrect because isosorbide mononitrate should not be crushed. Choice C does not specify a particular time for medication administration. Choice D is incorrect because isosorbide mononitrate is not meant to be taken as needed for chest pain; it is part of a long-term therapy plan.
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A nurse is administering metformin to a client with type 2 diabetes. Which of the following adverse effects should the nurse monitor for in this client?
- A. Diarrhea
- B. Hyperglycemia
- C. Hypoglycemia
- D. Lactic acidosis
Correct Answer: D
Rationale: The correct answer is D, Lactic acidosis. Lactic acidosis is a rare but serious adverse effect of metformin use. Metformin is not known to cause hyperglycemia or hypoglycemia. Diarrhea is a common gastrointestinal side effect of metformin but is not as serious as lactic acidosis, which requires immediate medical attention.
A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?
- A. Advise the client to take the medication once daily at bedtime
- B. This medication is for the acute management of asthma
- C. Avoid dairy products while taking this medication
- D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up
Correct Answer: A
Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.
A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?
- A. Osteoporosis
- B. Hypertension
- C. Peptic ulcer disease
- D. Immunosuppression
Correct Answer: C
Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.
A nurse is providing client education regarding lithium therapy. Which of the following instructions should the nurse include?
- A. Take with food to decrease nausea
- B. Avoid excessive intake of caffeinated beverages
- C. Monitor for signs of dehydration
- D. Restrict salt intake to prevent water retention
Correct Answer: B
Rationale: The correct answer is B. The nurse should instruct the client to avoid excessive intake of caffeinated beverages as they can interfere with lithium levels. Option A is incorrect as lithium is usually recommended to be taken on an empty stomach. Option C is not directly related to lithium therapy. Option D is not a typical instruction for lithium therapy.
A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?
- A. Hemoglobin (Hgb)
- B. Prothrombin time (PT)
- C. Bleeding time
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.