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A client is prescribed atorvastatin (Lipitor) for hyperlipidemia. Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the morning.
- B. Avoid consuming grapefruit juice.
- C. Increase intake of dairy products.
- D. Take the medication with food.
Correct Answer: B
Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the client to avoid consuming grapefruit juice. Grapefruit juice can increase the risk of atorvastatin (Lipitor) toxicity by inhibiting its metabolism. Atorvastatin is typically taken in the evening because cholesterol synthesis occurs at night. Increasing dairy intake is not specifically recommended for atorvastatin use, and the medication can be taken with or without food.
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A client is receiving desmopressin acetate (DDAVP), and a healthcare provider is monitoring for adverse effects. Which of the following indicates the presence of an adverse effect?
- A. Insomnia
- B. Drowsiness
- C. Weight loss
- D. Increased urination
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:
- A. 1 hour after each meal
- B. Once daily, at the same time each day
- C. 15 minutes before breakfast, lunch, and dinner
- D. Before each meal, based on the blood glucose level
Correct Answer: B
Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.
Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history?
- A. Gout
- B. Asthma
- C. Thrombophlebitis
- D. Myocardial infarction
Correct Answer: C
Rationale: Megestrol acetate can increase the risk of thromboembolic events. Clients with a history of thrombophlebitis should not receive this medication due to the increased risk of thromboembolic events. Therefore, the nurse should contact the registered nurse if thrombophlebitis is documented in the client's history to ensure appropriate medication management.
A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?
- A. The development of complaints of insomnia
- B. The development of audible expiratory wheezes
- C. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
- D. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication
Correct Answer: B
Rationale: The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.
A client is prescribed alendronate (Fosamax) for the treatment of osteoporosis. Which instruction should the nurse provide to the client?
- A. Take the medication at bedtime.
- B. Take the medication with a full glass of water.
- C. Lie down for 30 minutes after taking the medication.
- D. Take the medication with food to avoid gastrointestinal upset.
Correct Answer: B
Rationale: The correct instruction for a client prescribed alendronate (Fosamax) for osteoporosis is to take the medication with a full glass of water first thing in the morning. It should be taken at least 30 minutes before any food, beverage, or other medication. The client should also remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. Taking alendronate at bedtime or with food is not recommended as it may reduce its absorption and effectiveness.