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A client with rheumatoid arthritis is prescribed methotrexate. What is the most important instruction the practical nurse (PN) should provide to the client?
- A. Take the medication on an empty stomach.
- B. Avoid taking folic acid supplements.
- C. Report any signs of infection immediately.
- D. Increase intake of vitamin C-rich foods.
Correct Answer: C
Rationale: Correct Answer: The most important instruction for a client taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. Early detection and treatment of infections are crucial to prevent complications. Instructing the client to be vigilant for signs of infection empowers them to take prompt action, enhancing their overall safety and well-being.
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A client with diabetes mellitus type 2 is prescribed glyburide. The nurse should monitor for which potential adverse effect?
- A. Hypoglycemia
- B. Weight gain
- C. Nausea
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct potential adverse effect to monitor for when a client with diabetes mellitus type 2 is prescribed glyburide is hypoglycemia. Glyburide can lead to hypoglycemia, particularly in individuals who do not eat regularly, by stimulating the release of insulin from the pancreas, which can lower blood sugar levels. It is crucial for the nurse to monitor for signs and symptoms of hypoglycemia, such as confusion, sweating, and palpitations, to prevent complications and provide timely interventions.
A client with a diagnosis of generalized anxiety disorder is prescribed escitalopram. The nurse should instruct the client that this medication may have which potential side effect?
- A. Drowsiness
- B. Dry mouth
- C. Nausea
- D. Headache
Correct Answer: A
Rationale: The correct potential side effect of escitalopram is drowsiness. Escitalopram is known to cause sedation, so clients should be advised to avoid activities that require mental alertness, such as driving, until they know how the medication affects them. Dry mouth, nausea, and headache are also common side effects of various medications but are not specifically associated with escitalopram.
A client with diabetes mellitus is prescribed insulin glargine. What information should the practical nurse (PN) provide to the client about this medication?
- A. Administer the insulin at mealtimes.
- B. Do not mix this insulin with other insulins.
- C. Shake the vial well before use.
- D. Store the insulin in the freezer.
Correct Answer: B
Rationale: Insulin glargine is a long-acting insulin that should not be mixed with other insulins in the same syringe. Mixing it with other insulins can alter its pharmacokinetics and effectiveness. Insulin glargine is usually administered at the same time each day, often at bedtime, to provide a consistent basal level of insulin over 24 hours.
A client with rheumatoid arthritis is prescribed leflunomide. What instruction should the nurse include in the client's teaching plan?
- A. Avoid alcohol while taking this medication.
- B. Take this medication with food to decrease gastrointestinal upset.
- C. Avoid sunlight while taking this medication.
- D. Report any signs of infection to the healthcare provider.
Correct Answer: A
Rationale: Leflunomide can increase sensitivity to sunlight. While it is important to avoid excessive sun exposure, the critical instruction for the client is to avoid alcohol while taking this medication. Alcohol can potentiate the hepatotoxic effects of leflunomide, making it crucial for the client to abstain from alcohol consumption to prevent liver damage.
A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?
- A. Increased appetite
- B. Dry mouth and increased thirst
- C. Tremors and polyuria
- D. Constipation
Correct Answer: B
Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.