A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?
- A. Take the medication at the same time every day.
- B. Discontinue the medication if a rash develops.
- C. Avoid consuming dairy products.
- D. Monitor blood pressure regularly.
Correct Answer: A
Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin.
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A client with gastroesophageal reflux disease (GERD) is prescribed omeprazole. The nurse should reinforce which instruction?
- A. Take this medication in the morning before breakfast.
- B. Take this medication with meals.
- C. Avoid taking this medication with antacids.
- D. Take this medication at bedtime.
Correct Answer: A
Rationale: The correct instruction for a client with GERD prescribed omeprazole is to take the medication in the morning before breakfast. Omeprazole works best when taken on an empty stomach, approximately 30 minutes before the first meal of the day. This timing maximizes its effectiveness in reducing stomach acid production and helps manage symptoms of GERD more efficiently.
A client with rheumatoid arthritis is prescribed methotrexate. The nurse should include which instruction in the client's teaching plan?
- A. Avoid alcohol while taking this medication.
- B. Take this medication with food to decrease gastrointestinal upset.
- C. Avoid sunlight while taking this medication.
- D. Report any signs of infection to the healthcare provider.
Correct Answer: C
Rationale: The correct instruction for a client prescribed methotrexate is to avoid sunlight while taking this medication. Methotrexate can increase sensitivity to sunlight, leading to skin reactions, so clients should limit sun exposure and use protective measures like sunscreen and clothing coverage to prevent adverse effects.
A healthcare professional prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's heart rate is 48 beats/min, respirations are 16 breaths/min, and blood pressure is 150/90 mmHg.
- A. Administer the dose and monitor the client's blood pressure regularly
- B. Apply a telemetry monitor before administering the dose
- C. Assess for orthostatic hypotension before administering the dose
- D. Withhold the scheduled dose and notify the healthcare provider
Correct Answer: D
Rationale: The client's low heart rate of 48 beats/min indicates bradycardia, a potential side effect of labetalol. Administering the dose in this case could further lower the heart rate, potentially causing adverse effects. Therefore, it is crucial to withhold the scheduled dose and notify the healthcare provider for further assessment and guidance.
The healthcare professional is caring for a patient with a new order for an oral laxative. Which is a contraindication in administering an oral laxative?
- A. Cardiac problems
- B. Abdominal pain of unknown origin
- C. Several hemorrhoids
- D. Chronic constipation
Correct Answer: B
Rationale: Administering an oral laxative to a patient with abdominal pain of unknown origin is contraindicated because it could be a sign of a more serious underlying condition that needs immediate medical evaluation. Giving a laxative in such a situation without proper diagnosis could potentially worsen the patient's condition or delay appropriate treatment.
A client with chronic kidney disease is prescribed ferric citrate. The nurse should monitor for which potential side effect?
- A. Constipation
- B. Diarrhea
- C. Nausea
- D. Hyperphosphatemia
Correct Answer: A
Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate.