A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the health care provider immediately and instruct the client to stop taking the medication?
- A. The client is experiencing vision and hearing loss.
- B. The client has an erection lasting longer than 2 hours.
- C. The client is complaining of nasal congestion.
- D. The client is complaining of feeling flushed.
Correct Answer: A
Rationale: The correct answer is A. If a client prescribed sildenafil for pulmonary hypertension experiences vision and/or hearing loss or an erection lasting more than 4 hours, the practical nurse should instruct the client to discontinue the medication immediately and notify the health care provider. These symptoms could indicate serious side effects that require prompt medical attention to prevent complications.
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What instructions should the PN reinforce with the client regarding the newly prescribed medications isosorbide dinitrate and hydrochlorothiazide?
- A. Instruct the client to use a soft bristle toothbrush.
- B. Instruct the client to slowly rise from a sitting or lying down position.
- C. Instruct the client to elevate their legs above the level of their heart.
- D. Instruct the client to limit the amount of fiber in their diet.
Correct Answer: B
Rationale: The correct instruction for the client is to slowly rise from a sitting or lying down position. Isosorbide dinitrate, a nitrate, and hydrochlorothiazide, a diuretic, can both cause hypotension. When used together, their additive effects can further lower blood pressure, leading to orthostatic hypotension. Instructing the client to change positions slowly helps prevent a sudden drop in blood pressure, reducing the risk of dizziness or falls.
The healthcare provider notes that a client has a new prescription for 20 mEq of potassium, IV site is inflamed but not tender, and has a blood flashback. What action should the healthcare provider take?
- A. Obtain a liter of normal saline with 20 mEq of KCl
- B. Contact the healthcare provider to clarify the prescription
- C. Withhold the prescription medication until a new IV is started
- D. Fax the prescription to the pharmacy for immediate dispensing
Correct Answer: B
Rationale: The healthcare provider should contact the prescriber to clarify the prescription because an inflamed IV site may indicate potential issues with administering the medication. It is important to ensure that the prescription is appropriate and safe for the client before proceeding with administration.
A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. What action should the nurse take?
- A. Explain that the medication may take time to show improvement in symptoms
- B. Withhold the medication and notify the healthcare provider
- C. Advise the client to undergo liver function tests
- D. Document the assessment findings in the electronic health record
Correct Answer: D
Rationale: In this scenario, the nurse's priority is to document the assessment findings in the electronic health record. This action is crucial for maintaining an accurate record of the client's health status and can provide valuable information for the healthcare team. Withholding medication or advising additional tests should only be done after consulting with the healthcare provider based on the documented assessment findings.
A client is prescribed cyclobenzaprine for muscle spasms. The nurse should instruct the client to avoid which substance while taking this medication?
- A. Alcohol
- B. Caffeine
- C. Nicotine
- D. Dairy products
Correct Answer: A
Rationale: The correct answer is A: Alcohol. When taking cyclobenzaprine, it is important to avoid alcohol as it can potentiate the central nervous system depressant effects of the medication. This interaction can lead to increased drowsiness, dizziness, and impaired coordination. Therefore, it is essential for the client to refrain from alcohol consumption while on cyclobenzaprine to prevent these adverse effects and ensure their safety.
A client with type 2 diabetes mellitus is prescribed semaglutide. The nurse should monitor for which potential adverse effect?
- A. Nausea
- B. Hypoglycemia
- C. Hyperglycemia
- D. Pancreatitis
Correct Answer: A
Rationale: The correct answer is A: Nausea. Semaglutide, a medication used to treat type 2 diabetes, is known to cause nausea as a potential adverse effect. It is important for the nurse to monitor the client for gastrointestinal symptoms, including nausea, after initiating treatment with semaglutide. While hypoglycemia and hyperglycemia are common concerns in diabetes management, they are not the primary adverse effects associated with semaglutide. Pancreatitis is a serious but rare adverse effect of GLP-1 receptor agonists like semaglutide, which should also be monitored for, but nausea is a more common and immediate concern.
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