A client with diabetes mellitus type 2 is prescribed metformin. What instruction should the nurse include in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid alcohol while taking this medication.
- C. Take this medication on an empty stomach.
- D. Report any signs of lactic acidosis to the healthcare provider.
Correct Answer: A
Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals. Taking metformin with meals helps to minimize gastrointestinal side effects, which are common with this medication. Choice B, avoiding alcohol, is a good practice due to the increased risk of lactic acidosis when alcohol is consumed with metformin; however, it is not the priority teaching point in this scenario. Taking metformin on an empty stomach (Choice C) is incorrect because it can increase the risk of gastrointestinal side effects. Reporting signs of lactic acidosis (Choice D) is important, but it is more related to monitoring for adverse effects rather than a primary teaching point for administration.
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The healthcare professional is creating a class for older adults in the community. Which information about laxative use in older adults would be important to include?
- A. Laxatives are not effective in older adults
- B. All laxatives are exactly the same
- C. Over-the-counter laxatives are misused
- D. Laxatives can cause potassium retention
Correct Answer: C
Rationale: It is important to include information about the misuse of over-the-counter laxatives in older adults as they often misuse these medications, which can lead to dependency and other health issues. Option A is incorrect as laxatives can be effective in older adults when used appropriately. Option B is incorrect because not all laxatives are the same, they have different mechanisms of action and side effects. Option D is incorrect because laxatives can actually cause electrolyte imbalances like potassium depletion rather than retention.
A client with schizophrenia is prescribed risperidone. Which statement by the client indicates the need for further teaching?
- A. I can stop taking this medication once I feel better.
- B. This medication may cause drowsiness.
- C. This medication might make me feel drowsy.
- D. I should avoid alcohol while taking this medication.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A home health care nurse observes that a client with Parkinson's syndrome is experiencing increased tremors and difficulty in movement. What should the nurse do in response to this finding?
- A. Report the observed finding to the healthcare provider right away
- B. Arrange a medical evaluation so the medication dose can be adjusted
- C. Schedule a return home visit in 2 weeks to monitor
- D. Explain that this is an expected progression of Parkinson's
Correct Answer: B
Rationale: In a client with Parkinson's syndrome experiencing increased tremors and movement difficulty, arranging a medical evaluation is crucial to adjust the medication dose. This proactive approach helps in managing the symptoms effectively. Reporting the finding to the healthcare provider may delay necessary adjustments in treatment. Scheduling a return home visit in 2 weeks may not address the immediate need for medication adjustment. Explaining that the progression is expected without taking action does not address the client's worsening symptoms.
A healthy 68-year-old client asks the practical nurse (PN) whether they should take the pneumococcal vaccine. Which statement should the PN offer to the client that provides the most accurate information about this vaccine?
- A. The vaccine is given annually before the flu season to those older than 50 years.
- B. The immunization is recommended for children younger than 2 years old and all adults 65 years or older.
- C. The vaccine is for all ages and is given primarily to those traveling overseas to areas of infection.
- D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.
Correct Answer: B
Rationale: The correct answer is B because it is usually recommended that children younger than 2 years old and adults 65 years or older get vaccinated against pneumococcal disease. This is because these age groups are more susceptible to severe complications from the infection. While the vaccine may be recommended for certain individuals with specific medical conditions at any age, the primary target groups are as mentioned in option B. Option A is incorrect as the pneumococcal vaccine is not given annually like the flu vaccine. Option C is incorrect because the vaccine is not primarily for travelers but for certain age groups and individuals with medical conditions at risk. Option D is incorrect as the vaccine's duration of protection can vary, and it is not guaranteed to prevent pneumococcal pneumonia for up to 5 years.
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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