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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. Stop taking the medication immediately.
- C. Increase intake of fluids and high-protein foods.
- D. Obtain transportation to the emergency department.
Correct Answer: A
Rationale: Fatigue and dizziness are common baclofen side effects, so avoiding hazardous activities is appropriate. Stopping abruptly, increasing fluids/protein, or seeking emergency care are not warranted without further assessment.
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Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?
- A. Use a straw to ingest.
- B. Swallow undiluted.
- C. Mix with an antacid.
- D. Take with a glass of milk.
Correct Answer: A
Rationale: Using a straw prevents tooth staining from ferrous sulfate. Undiluted swallowing risks staining, antacids reduce absorption, and milk inhibits iron absorption due to calcium.
A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?
- A. Reduce daily fluid intake.
- B. Stand and sit up slowly.
- C. Take the medication early in the day.
- D. Use a twice-a-week dosing schedule.
Correct Answer: B
Rationale: Tamsulosin may cause orthostatic hypotension, so standing and sitting slowly prevents dizziness or falls. Fluid reduction, early dosing, or twice-weekly schedules are incorrect for tamsulosin.
The healthcare provider prescribes enoxaparin sodium 80 mg SUBQ twice daily. The nurse is preparing a preloaded 1 mL syringe labeled, 'Enoxaparin sodium injection, USP 60 mg/0.6 mL.' How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
Correct Answer: 0.8
Rationale: Desired dose = 80 mg, Concentration = 60 mg/0.6 mL = 100 mg/mL. Volume = 80 mg / 100 mg/mL = 0.8 mL.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
- A. Stores the medication at room temperature.
- B. Primes the inhaler with 7 pumps.
- C. Attaches spacer device to the inhaler.
- D. Rinses the mouth after each use.
Correct Answer: B
Rationale: Priming an ipratropium inhaler with 7 pumps is excessive; typically, 2–3 pumps are needed if unused for a period. Room temperature storage, spacer use, and mouth rinsing are correct practices.
A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?
- A. Increased anxiety and nervousness have been reported by those taking feverfew.
- B. Those with allergies to chamomile, ragweed, or yarrow should not take feverfew.
- C. Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew.
- D. Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
Correct Answer: B
Rationale: Feverfew can cause allergic reactions in individuals allergic to chamomile, ragweed, or yarrow, making this critical to prevent serious reactions. Anxiety, GI effects, or NSAID interactions are less urgent.