A client with angina pectoris has been prescribed nitroglycerin tablets prn for chest pain. Which statement by the client causes the practical nurse (PN) to clarify instructions for this client?
- A. I will take one tablet every 5 minutes, up to three tablets.
- B. I should take one tablet at the onset of angina and stop activity.
- C. I need to replace nitroglycerin tablets every 3 to 6 months to maintain freshness.
- D. I should ensure that I chew the pill completely before swallowing it.
Correct Answer: D
Rationale: Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest. One tablet should be placed under the tongue (sublingually), not chewed or swallowed. One tablet can be taken every 5 minutes, up to three doses. If pain relief not achieved after taking three pills, seek medical attention immediately. Nitroglycerin should be replaced every 3 to 6 months. Nitroglycerin pain relief should occur in 5 minutes and duration should last 30 minutes.
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Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the healthcare provider?
- A. I should notify the healthcare provider if the color of my urine turns pink.
- B. I should never stop taking this medication abruptly.
- C. I should monitor my glucose levels closely since I am diabetic.
- D. I should take the medicine with antacids if gastric upset occurs.
Correct Answer: D
Rationale: The correct answer is D because antacids should not be taken with phenytoin as they can decrease its effects. Taking antacids with phenytoin is not recommended. Choice A is correct; pink discoloration of urine can occur with phenytoin use. Choice B is also correct; abruptly stopping phenytoin can lead to seizures. Choice C is correct; monitoring glucose levels is important as phenytoin can increase glucose levels. Therefore, the statement about using antacids with phenytoin needs clarification.
A client with a diagnosis of generalized anxiety disorder is prescribed venlafaxine. The nurse should instruct the client that this medication may have which potential side effect?
- A. Nausea
- B. Dry mouth
- C. Insomnia
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Nausea. Venlafaxine, a medication used for generalized anxiety disorder, can commonly cause nausea as a side effect. It is essential for clients to be aware of this potential side effect and advised to take the medication with food if nausea occurs. Choices B, C, and D are incorrect because dry mouth, insomnia, and headache are less commonly associated side effects of venlafaxine compared to nausea.
A client with diabetes mellitus type 2 is prescribed canagliflozin. The nurse should include which instruction in the client's teaching plan?
- A. Report any signs of urinary tract infection.
- B. Take this medication with meals.
- C. Avoid alcohol while taking this medication.
- D. Avoid taking this medication with grapefruit juice.
Correct Answer: A
Rationale: The correct instruction to include in the client's teaching plan is to report any signs of urinary tract infection. Canagliflozin, a medication used in diabetes mellitus type 2, can increase the risk of urinary tract infections. Instructing the client to report any signs of infection is crucial for early intervention and management. Choices B, C, and D are incorrect because there is no specific requirement to take canagliflozin with meals, avoid alcohol, or restrict grapefruit juice consumption while on this medication.
A practical nurse (PN) is preparing to administer enoxaparin to a client. What is the most important action for the PN to take before administering this medication?
- A. Assess the client's blood pressure.
- B. Check the client's platelet count.
- C. Monitor the client's urine output.
- D. Review the client's blood glucose level.
Correct Answer: B
Rationale: The correct answer is to check the client's platelet count. Enoxaparin can lead to thrombocytopenia (low platelet count), which can increase the risk of bleeding. Therefore, assessing the platelet count before administering enoxaparin is crucial to ensure that it is within a safe range. Assessing the client's blood pressure (Choice A) is not directly related to enoxaparin administration. Monitoring urine output (Choice C) and reviewing blood glucose levels (Choice D) are not essential actions before administering enoxaparin.
A client with hypertension is prescribed clonidine. The nurse should monitor the client for which potential side effect?
- A. Hypotension
- B. Tachycardia
- C. Dizziness
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Hypotension. Clonidine, a medication used to treat hypertension, can cause a lowering of blood pressure leading to hypotension as a potential side effect. Monitoring for hypotension is essential to prevent complications such as dizziness, fainting, or falls. Option B, Tachycardia, is incorrect as clonidine typically causes bradycardia or a decreased heart rate. Option C, Dizziness, can occur due to hypotension caused by clonidine. Option D, Hyperglycemia, is not a common side effect associated with clonidine use.