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A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?
- A. Avoid hazardous activities until symptoms subside
- B. Contact the healthcare provider immediately
- C. Continue taking the medication every day
- D. Stop taking the medication until the unpleasant side effects wear off
Correct Answer: A
Rationale: The correct instruction for the nurse to provide is to advise the client to avoid hazardous activities until the symptoms of fatigue and dizziness subside. These side effects can impair the client's ability to engage in activities that require alertness and coordination, posing a risk for accidents. Contacting the healthcare provider immediately may not be necessary unless the symptoms worsen or persist. Continuing to take the medication every day without addressing the side effects can lead to further complications. Stopping the medication abruptly without healthcare provider guidance can also be risky and may not be necessary if the symptoms improve with time.
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A client with a history of myocardial infarction is prescribed atorvastatin. The nurse should monitor the client for which potential adverse effect?
- A. Liver damage
- B. Kidney damage
- C. Muscle pain
- D. Increased appetite
Correct Answer: C
Rationale: The correct answer is C: Muscle pain. Atorvastatin can cause muscle pain, which may indicate rhabdomyolysis, a serious adverse effect. Rhabdomyolysis is a condition where muscle breakdown releases a protein (myoglobin) into the bloodstream, potentially leading to kidney damage. Liver damage (choice A) is a less common side effect of atorvastatin compared to muscle pain. Kidney damage (choice B) is not a direct adverse effect of atorvastatin but can occur indirectly if rhabdomyolysis is severe. Increased appetite (choice D) is not a known adverse effect of atorvastatin.
A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should include which instruction 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 pancreatitis to the healthcare provider.
Correct Answer: D
Rationale: The correct instruction to include in the teaching plan for a client prescribed sitagliptin is to report any signs of pancreatitis to the healthcare provider. Sitagliptin is generally taken with meals to reduce gastrointestinal side effects. Therefore, choice A, 'Take this medication with meals,' is incorrect. Sitagliptin does not have specific interactions with alcohol, so there is no need to advise the client to avoid alcohol, making choice B incorrect. Taking sitagliptin on an empty stomach is not recommended, so choice C is also incorrect. Pancreatitis is a rare but serious side effect of sitagliptin, so it is crucial for the client to report any signs or symptoms to their healthcare provider promptly.
Twenty-four hours after starting to take oral penicillin for strep throat, a client calls the nurse to report the onset of a rash on the chest. What action should the nurse implement?
- A. Instruct the client to discontinue the penicillin immediately
- B. Instruct the client regarding the use of topical analgesic cream PRN
- C. Question the client about any other related symptoms
- D. Reinforce the need to take all doses of the penicillin
Correct Answer: A
Rationale: In this scenario, the client has developed a rash after starting oral penicillin, which can indicate an allergic reaction. It is crucial for the nurse to instruct the client to discontinue the penicillin immediately. Continuing the medication can potentially lead to severe allergic reactions. Instructing about topical analgesic cream or questioning about other related symptoms may delay appropriate action in case of a severe allergic reaction. Reinforcing the need to complete all doses is not appropriate when an allergic reaction is suspected, as safety takes precedence over completing the antibiotic course.
A client with hypertension is prescribed valsartan. The nurse should monitor the client for which potential side effect?
- A. Hypotension
- B. Tachycardia
- C. Hyperglycemia
- D. Hyponatremia
Correct Answer: A
Rationale: The correct answer is A: Hypotension. Valsartan is an angiotensin II receptor blocker that can cause hypotension as a side effect by dilating blood vessels. Monitoring blood pressure is crucial to prevent complications related to low blood pressure. Choice B, Tachycardia, is incorrect because valsartan typically does not cause an increase in heart rate. Choice C, Hyperglycemia, is not a common side effect of valsartan. Choice D, Hyponatremia, is also unlikely with valsartan use.
A client with diabetes mellitus type 2 is prescribed empagliflozin. The nurse should monitor for which potential adverse effect?
- A. Genital infections
- B. Hypoglycemia
- C. Hyperglycemia
- D. Nausea
Correct Answer: A
Rationale: The correct answer is A: Genital infections. Empagliflozin, a medication commonly used to treat type 2 diabetes, is associated with an increased risk of genital infections. This is due to its mechanism of action, which involves promoting the excretion of glucose through urine, creating a more favorable environment for fungal or bacterial growth in the genital area. Choices B and C, hypoglycemia and hyperglycemia, are less likely adverse effects of empagliflozin. Empagliflozin actually carries a low risk of causing hypoglycemia since it works independently of insulin. Nausea (Choice D) is not a commonly reported adverse effect of empagliflozin, making it an incorrect choice in this scenario.