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A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?
- A. Reduce daily fluid intake.
- B. Stand and sit up slowly.
- C. Take the medication early in the day.
- D. Use a twice-a-week dosing schedule.
Correct Answer: B
Rationale: Tamsulosin may cause orthostatic hypotension, so standing and sitting slowly prevents dizziness or falls. Fluid reduction, early dosing, or twice-weekly schedules are incorrect for tamsulosin.
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Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment?
- A. Assess the client's strength in moving and turning in the bed.
- B. Observe the skin integrity of the client's rectal and sacral areas.
- C. Evaluate the client's ability to recognize the urge to defecate.
- D. Determine the frequency and consistency of bowel movements.
Correct Answer: D
Rationale: Assessing bowel movement frequency and consistency is critical to determine the need for a laxative and monitor its effectiveness. Strength, skin integrity, and urge recognition are less directly related to laxative administration.
A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?
- A. pH.
- B. Phosphate.
- C. Potassium.
- D. Calcium.
Correct Answer: B
Rationale: Calcium acetate lowers phosphate levels in CKD by binding dietary phosphate. A decreased phosphate level indicates effectiveness. pH, potassium, and calcium are not primary targets.
The nurse prepares to administer a scheduled dose of labetalol PO to a client with hypertension. The client's vital signs are a temperature of 99° F (37.2° C), a heart rate of 48 beats/minute, respirations of 16 breaths/minute, and a blood pressure of 150/90 mm Hg. Which action should the nurse take?
- A. Apply a telemetry monitor before administering the dose.
- B. Assess for orthostatic hypotension before administering the dose.
- C. Administer the dose and monitor the client's blood pressure regularly.
- D. Withhold the scheduled dose and notify the healthcare provider.
Correct Answer: D
Rationale: A heart rate of 48 beats/minute indicates bradycardia, a concern with labetalol (a beta-blocker). Withholding the dose and notifying the provider is appropriate to prevent worsening bradycardia.
A female client with osteoporosis has been taking a weekly dose of oral risedronate for several weeks. The client calls the clinic nurse to report increasing 'heartburn.' How should the nurse respond?
- A. Ask the client to describe how she takes the medication.
- B. Remind the client to take the medication with plenty of water.
- C. Advise the client to go to the nearest emergency department.
- D. Suggest use of an antacid two hours after the medication.
Correct Answer: A
Rationale: Risedronate can cause esophageal irritation if not taken properly. Assessing the client’s administration technique (e.g., with water, staying upright) identifies potential causes of heartburn, guiding further intervention.
A client with a history of smoking cigarettes for many years arrives at the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?
- A. Administer each dose with at least 8 ounces of water.
- B. Consume tyramine-free foods while taking the medicine.
- C. Be aware that difficulty sleeping and weight loss may occur.
- D. Notify the healthcare provider if experiencing changes in taste.
Correct Answer: C
Rationale: Bupropion may cause insomnia and weight loss, which are important side effects for the client to understand. Water intake, tyramine-free diets, and taste changes are not primary concerns with bupropion.