A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?
- A. Use the medication as a rescue inhaler.
- B. Rinse your mouth after using the inhaler.
- C. Take the medication on an empty stomach.
- D. Take the medication with a full glass of water.
Correct Answer: B
Rationale: Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.
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A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?
- A. 5 to 10 mcg/mL
- B. 10 to 20 mcg/mL
- C. 20 to 30 mcg/mL
- D. 30 to 40 mcg/mL
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?
- A. Keep insulin vials refrigerated at all times.
- B. Rotate the insulin injection sites systematically.
- C. Increase the amount of insulin before unusual exercise.
- D. Monitor the urine acetone level to determine the insulin dosage.
Correct Answer: B
Rationale: When a client is stabilized with daily insulin injections, it is crucial to rotate the injection sites systematically. This practice helps prevent the development of lipodystrophy, which can affect insulin absorption and lead to inconsistent glucose control. Additionally, rotating sites minimizes discomfort and tissue damage, ensuring optimal insulin delivery and effectiveness.
The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The nurse evaluates the need for further teaching when the client states which of the following?
- A. I can skip a dose once a week.
- B. I need to change my position slowly.
- C. I take the pill after breakfast each day.
- D. If I get a bad headache, I should call my doctor immediately.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is prescribed metronidazole (Flagyl) for a trichomoniasis infection. Which of the following should the nurse include in the teaching plan?
- A. Avoid consuming alcohol while taking this medication.
- B. Take the medication with food.
- C. Increase fluid intake to prevent kidney stones.
- D. Report any gastrointestinal upset to the healthcare provider.
Correct Answer: A
Rationale: The correct answer is A. Metronidazole (Flagyl) can cause a disulfiram-like reaction when taken with alcohol, resulting in severe nausea, vomiting, and headache. Therefore, the client should be advised to avoid alcohol while taking this medication to prevent adverse effects. Avoiding alcohol is crucial to prevent these reactions and ensure the effectiveness of the treatment. The other options are not directly related to the specific medication or the condition being treated.
The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
- A. Diarrhea
- B. Heartburn
- C. Flatulence
- D. Constipation
Correct Answer: B
Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.