A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse include in the teaching plan?
- A. Take the medication with meals.
- B. Monitor for signs of hypoglycemia.
- C. Avoid alcohol while taking this medication.
- D. Take the medication at bedtime.
Correct Answer: C
Rationale: Clients taking metformin (Glucophage) should avoid alcohol as it can increase the risk of lactic acidosis. Metformin should be taken with meals to reduce gastrointestinal upset. While hypoglycemia is less common with metformin compared to other diabetes medications, clients should still be aware of its symptoms.
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A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:
- A. Watch for irritability as a side effect.
- B. Take the tablet with a full glass of water.
- C. Take an extra dose if the cough is accompanied by fever.
- D. Crush the sustained-release tablet if immediate relief is needed.
Correct Answer: B
Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.
A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?
- A. Use the medication as a rescue inhaler.
- B. Rinse your mouth after using the inhaler.
- C. Take the medication on an empty stomach.
- D. Take the medication with a full glass of water.
Correct Answer: B
Rationale: Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.
A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?
- A. I will avoid potassium-rich foods.
- B. I will not use a salt substitute.
- C. I will monitor my weight daily.
- D. I will increase my fluid intake as prescribed.
Correct Answer: A
Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.
A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:
- A. Should always be taken with food or antacids
- B. Should be double-dosed if one dose is forgotten
- C. Causes orange discoloration of sweat, tears, urine, and feces
- D. May not be discontinued independently if symptoms are gone in 3 months
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:
- A. Take the medication with food.
- B. Increase fluid intake to 2000 to 3000 mL daily.
- C. Decrease sodium intake while taking the medication.
- D. Increase potassium intake while taking the medication.
Correct Answer: B
Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.
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