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A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?
- A. It can take several weeks before you feel like the medication is helping.
- B. Take the medication just before bedtime to promote sleep.
- C. You should take the medication when needed for obsessive urges.
- D. Monitor for weight gain while taking this medication.
Correct Answer: A
Rationale: The correct instruction for the nurse to include when teaching a client with OCD who has a new prescription for Paroxetine is that it can take several weeks before the client feels like the medication is helping. Paroxetine, like other selective serotonin reuptake inhibitors (SSRIs), can take 1 to 4 weeks before the client reaches the full therapeutic benefit. Therefore, it is important to inform the client about this delay in onset of action to manage their expectations and promote adherence to the treatment plan. Choices B, C, and D are incorrect because taking Paroxetine before bedtime is not necessary, it should be taken consistently at the same time each day; Paroxetine is usually taken regularly, not as needed; and while monitoring weight is important, it is not a specific instruction related to the onset of action for Paroxetine.
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A client has been prescribed Valsartan. Which of the following adverse effects should the nurse monitor?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Bradycardia
- D. Hypercalcemia
Correct Answer: A
Rationale: Corrected Rationale: Valsartan is an angiotensin II receptor blocker (ARB) that can lead to hyperkalemia by inhibiting the action of aldosterone. Hyperkalemia is a potential adverse effect, making it essential for the nurse to closely monitor the client's potassium levels to prevent complications such as cardiac arrhythmias.
Incorrect Options Rationale:
- Option B, Hypoglycemia, is not a common adverse effect of Valsartan.
- Option C, Bradycardia, is not typically associated with Valsartan use.
- Option D, Hypercalcemia, is not a known adverse effect of Valsartan; instead, Valsartan can lead to hyperkalemia.
A client has a new prescription for Omeprazole. Which of the following instructions should the nurse include?
- A. Take this medication before meals.
- B. Take this medication with food.
- C. Take this medication at bedtime.
- D. Take this medication with antacids.
Correct Answer: A
Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that should be taken before meals to be most effective in reducing stomach acid production. Taking it before meals allows the medication to inhibit the proton pumps in the stomach when they are most active, leading to better control of acid secretion. Choice B is incorrect because taking Omeprazole with food may reduce its effectiveness as food can interfere with its absorption. Choice C is incorrect as Omeprazole is more effective when taken before meals. Choice D is incorrect as Omeprazole should not be taken with antacids as they can reduce its absorption.
When educating a client with early Parkinson's disease about pramipexole, what adverse effect should the nurse advise the client to monitor for?
- A. Hallucinations
- B. Increased salivation
- C. Diarrhea
- D. Discoloration of urine
Correct Answer: A
Rationale: The correct answer is A: Hallucinations. Pramipexole can lead to hallucinations, especially within 9 months of starting the medication, and may necessitate discontinuation. Hallucinations are a serious adverse effect that the client should be aware of and report promptly to their healthcare provider for evaluation and management. Increased salivation (choice B), diarrhea (choice C), and discoloration of urine (choice D) are not common adverse effects associated with pramipexole and are not typically emphasized in client education for this medication.
A healthcare provider is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare provider plan to take?
- A. Administer IM Enoxaparin along with the Alteplase dose.
- B. Hold direct pressure on puncture sites for up to 30 minutes.
- C. Administer Aminocaproic acid IV prior to alteplase infusion.
- D. Prepare to administer Alteplase within 8 hours of manifestation onset.
Correct Answer: B
Rationale: When administering IV Alteplase for a massive Pulmonary Embolism, the healthcare provider should plan to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This is crucial to prevent bleeding complications at the puncture sites. Choice A is incorrect because Enoxaparin is not usually administered along with Alteplase for a Pulmonary Embolism. Choice C is incorrect because Aminocaproic acid is not typically given prior to alteplase infusion in this situation. Choice D is incorrect because Alteplase should be administered within 2 hours of onset of manifestations for Pulmonary Embolism, not within 8 hours.
A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take the medication before bed.
- B. Monitor for increased blood pressure.
- C. Take the medication on an empty stomach.
- D. Monitor for leg cramps.
Correct Answer: D
Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.