Nokea
A client who has a new prescription for warfarin is being educated by a healthcare professional about monitoring for adverse effects. Which of the following statements by the client indicates an understanding of the teaching?
- A. 'I should use a soft toothbrush to brush my teeth.'
- B. 'I will double my dose if I miss one.'
- C. 'I should increase my intake of leafy green vegetables.'
- D. 'I will contact my doctor if I notice any unusual bleeding or bruising.'
Correct Answer: D
Rationale: The correct answer is D: 'I will contact my doctor if I notice any unusual bleeding or bruising.' This statement indicates a good understanding of the teaching regarding warfarin. Warfarin is an anticoagulant medication that increases the risk of bleeding. Contacting the doctor if unusual bleeding or bruising is noticed is essential as it can help prevent serious complications. Choices A, B, and C are incorrect. Using a soft toothbrush is generally recommended for oral hygiene but is not directly related to monitoring for adverse effects of warfarin. Doubling the dose of warfarin if a dose is missed is dangerous and can increase the risk of bleeding. Increasing the intake of leafy green vegetables can interfere with warfarin's effectiveness as they contain vitamin K, which antagonizes warfarin's anticoagulant effects.
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A client has a new prescription for nitroglycerin. Which of the following instructions should the nurse include?
- A. Store the medication in a cool, dry place.
- B. Take the medication as directed by the healthcare provider.
- C. Take the medication 30 minutes before meals.
- D. Take the medication at the first sign of chest pain.
Correct Answer: D
Rationale: Instructing the client to take nitroglycerin at the first sign of chest pain is crucial for immediate relief of angina symptoms. Nitroglycerin is a fast-acting medication that helps dilate blood vessels, improving blood flow to the heart muscle. Therefore, prompt administration at the onset of chest pain is essential to alleviate anginal episodes effectively. Choices A, B, and C are incorrect because storing the medication properly, taking it as directed, or before meals are not specific instructions for managing acute anginal episodes, which require immediate action for symptom relief.
A client has a new prescription for atenolol. Which of the following instructions should be included in the discharge teaching?
- A. Take the medication at bedtime.
- B. Monitor your heart rate daily.
- C. Increase your intake of potassium-rich foods.
- D. Avoid consuming dairy products.
Correct Answer: B
Rationale: The correct answer is to instruct the client to monitor their heart rate daily when taking atenolol. Atenolol can lead to bradycardia, a slow heart rate. By monitoring heart rate daily, the client can promptly identify any significant changes and seek medical attention if necessary. This proactive approach enables early detection of potential adverse effects of atenolol, contributing to the client's safety and well-being. Choices A, C, and D are incorrect because taking atenolol at bedtime, increasing potassium-rich foods intake, or avoiding dairy products are not specific instructions related to the potential side effects of atenolol.
A healthcare professional is preparing to administer a unit of packed red blood cells to a client. Which of the following actions should the healthcare professional take?
- A. Prime the blood tubing with normal saline.
- B. Verify the client's identity using two identifiers.
- C. Infuse the blood rapidly over 30 minutes.
- D. Obtain the client's vital signs every 4 hours during the transfusion.
Correct Answer: B
Rationale: Verifying the client's identity using two identifiers is a critical patient safety measure to ensure the correct patient receives the blood transfusion. This process involves checking the patient's identity using at least two unique identifiers, such as name, date of birth, or medical record number, to prevent administration errors. Priming the blood tubing with normal saline is necessary to ensure there are no air bubbles in the tubing, but it is not the immediate action required before administering the blood. Infusing packed red blood cells over 30 minutes is generally too rapid and can lead to adverse reactions; a slower rate is recommended for safe administration. Obtaining vital signs every 4 hours during the transfusion is not frequent enough to monitor the client adequately for potential transfusion reactions or complications; vital signs should be monitored more frequently, especially during the initial phase of the transfusion.
A client has a new prescription for albuterol. Which of the following instructions should the nurse include?
- A. Use the inhaler every 4 hours around the clock.
- B. Shake the inhaler well before use.
- C. Rinse your mouth with water after each use.
- D. Use the inhaler while lying down.
Correct Answer: B
Rationale: Shaking the inhaler well before use is crucial as it helps ensure proper mixing of the medication, which is essential for effective delivery of the drug to the lungs. This step is important for optimal therapeutic effects of albuterol inhalation. Choices A, C, and D are incorrect. Using the inhaler every 4 hours around the clock without specifying a maximum number of doses can lead to overuse. Rinsing the mouth with water after each use is typically advised for inhaled corticosteroids to reduce the risk of oral thrush, not for albuterol. Using the inhaler while lying down is not recommended as it may lead to improper medication delivery to the lungs.
A client has a new prescription for alendronate. Which of the following instructions should be included in the teaching?
- A. Take the medication with a full glass of water.
- B. Lie down for 30 minutes after taking the medication.
- C. Take the medication at bedtime.
- D. Avoid dairy products while taking the medication.
Correct Answer: A
Rationale: The correct instruction for taking alendronate is to take it with a full glass of water to prevent esophageal irritation. This helps ensure proper absorption and reduces the risk of irritation to the esophagus. Choice B is incorrect because patients should remain upright for at least 30 minutes after taking alendronate to prevent esophageal irritation. Choice C is incorrect as alendronate should be taken in the morning on an empty stomach. Choice D is also incorrect as there is no specific requirement to avoid dairy products while taking alendronate.