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A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Rise slowly from a sitting position.
- C. Avoid salt substitutes.
- D. Avoid exposure to sunlight.
Correct Answer: C
Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.
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A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?
- A. Monitor for signs of bleeding.
- B. Avoid foods high in vitamin K.
- C. Expect to have increased urination.
- D. Take the medication with an antacid.
Correct Answer: A
Rationale: The correct instruction for a client starting Warfarin is to monitor for signs of bleeding. Warfarin is an anticoagulant that increases the risk of bleeding; therefore, it is crucial for the client to watch for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stools, or unusual bleeding from gums or nose. If any of these signs occur, the client should promptly report them to their healthcare provider for further evaluation and management. Choices B, C, and D are incorrect because avoiding foods high in vitamin K is related to other medications like Coumadin, increased urination is not a common side effect of Warfarin, and taking Warfarin with an antacid can potentially interfere with its absorption.
A client has a new prescription for Metronidazole. Which of the following instructions should be included?
- A. Avoid drinking alcohol while taking this medication.
- B. Take the medication on an empty stomach.
- C. Increase your intake of green, leafy vegetables.
- D. Discontinue the medication if you experience a metallic taste.
Correct Answer: A
Rationale: The correct instruction for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, resulting in severe nausea, vomiting, and other adverse effects. Therefore, it is crucial for clients to refrain from consuming alcohol during treatment to prevent these potential complications. Choice B is incorrect because Metronidazole can be taken with or without food. Choice C is irrelevant as there is no specific requirement to increase green, leafy vegetable intake with Metronidazole. Choice D is incorrect as a metallic taste is a known side effect of Metronidazole but does not necessarily indicate the need to discontinue the medication.
A client has a new prescription for colchicine to treat gout. Which of the following instructions should be included?
- A. Take this medication with food if nausea develops.
- B. Monitor for muscle pain.
- C. Expect to have increased bruising.
- D. Increase your intake of grapefruit juice.
Correct Answer: B
Rationale: Monitoring for muscle pain is crucial when taking colchicine because it can lead to rhabdomyolysis, a serious condition characterized by muscle breakdown. This adverse effect needs prompt identification to prevent complications. Choices A, C, and D are incorrect because taking colchicine with food, experiencing increased bruising, or increasing grapefruit juice intake are not relevant instructions for a client prescribed colchicine for gout.
What instruction should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine for a client with poison ivy?
- A. Administer the medication with food.
- B. Chew on sugarless gum or suck on hard, sour candies.
- C. Place a humidifier at your bedside every evening.
- D. Discontinue the medication and notify your provider.
Correct Answer: B
Rationale: The correct instruction for dry mouth associated with diphenhydramine is to chew on sugarless gum or suck on hard, sour candies. These actions stimulate saliva production, providing relief from dry mouth. Administering the medication with food (Choice A) may help reduce stomach upset but won't address dry mouth. Placing a humidifier at the bedside (Choice C) can help with dry air-related issues but won't specifically target dry mouth. Discontinuing the medication (Choice D) without consulting the provider is not recommended and may lead to inadequate treatment of poison ivy.
The nurse is caring for a client receiving tamoxifen (Nolvadex) for breast cancer. Which side effect should the nurse monitor for?
- A. Hot flashes
- B. Hair loss
- C. Nausea
- D. Diarrhea
Correct Answer: A
Rationale: Tamoxifen, an estrogen receptor modulator, treats breast cancer but blocks estrogen in some tissues, causing hot flashes , a common menopausal-like effect. Monitoring this ensures client comfort and adherence, as it's frequent and distressing. Hair loss is more chemotherapy-related, not tamoxifen. Nausea and diarrhea occur less often and are less specific. Hot flashes align with tamoxifen's anti-estrogenic action, a key consideration in breast cancer management where long-term use is common. This focus aids in symptom management, distinguishing it from cytotoxic effects, making A the priority side effect to monitor.