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When educating a client with a new prescription for Omeprazole to manage GERD, which of the following information should the nurse include?
- A. Take the medication before meals.
- B. You may need to take this medication for a long time.
- C. Increase your intake of vitamin C while taking this medication.
- D. Expect immediate relief of symptoms.
Correct Answer: A
Rationale: The correct answer is to take the medication before meals. Omeprazole should be taken before meals to ensure its effectiveness in reducing stomach acid production. This timing allows the medication to work on reducing acid secretion when the stomach is most actively producing it, leading to better control of symptoms. Choice B is incorrect because not all patients with GERD need to take Omeprazole for the rest of their lives; the duration of treatment varies. Choice C is incorrect as there is no specific recommendation to increase vitamin C intake while taking Omeprazole. Choice D is incorrect because Omeprazole may take a few days to start providing symptom relief, so immediate relief should not be expected.
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A healthcare professional is reviewing the medical history of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following findings should the healthcare professional report to the provider?
- A. Hemoglobin A1C of 7.5%
- B. Creatinine level of 1.2 mg/dL
- C. BUN level of 18 mg/dL
- D. Liver function tests showing AST of 50 units/L
Correct Answer: D
Rationale: The correct answer is D. Elevated AST levels in liver function tests should be reported to the provider when a client is prescribed Metformin due to the potential risk of hepatotoxicity associated with the medication. Elevated Hemoglobin A1C (choice A), Creatinine level within normal range (choice B), and BUN level within normal range (choice C) are not directly concerning when initiating Metformin therapy.
Which of the following has the shortest elimination half-life?
- A. Naloxone
- B. Morphine
- C. Methadone
- D. Remifentanil
Correct Answer: D
Rationale: Elimination half-life measures how quickly a drug is cleared from plasma. Naloxone's half-life is about 1-2 hours, used for opioid reversal. Morphine's is 2-4 hours, reflecting its duration as an analgesic. Methadone's is long, 15-60 hours, suiting addiction maintenance. Fentanyl's is 2-4 hours, typical for anesthesia. Remifentanil, an ultra-short-acting opioid, has a half-life of 3-10 minutes due to rapid esterase metabolism, making it ideal for procedures needing quick offset. Its brevity contrasts with others, ensuring minimal residual effects, a key advantage in critical care settings where rapid recovery is essential.
A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?
- A. Apply the patch to a hairless area of the body.
- B. Remove the patch every 12 hours.
- C. Massage the patch after applying it.
- D. Place the patch over a hairless area of the body.
Correct Answer: D
Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.
A client has a new prescription for Atenolol. Which of the following instructions should the nurse provide?
- A. Take this medication with grapefruit juice.
- B. Monitor your blood pressure and heart rate regularly.
- C. You may experience a rapid heart rate.
- D. Increase your intake of potassium-rich foods.
Correct Answer: B
Rationale: The correct answer is B: 'Monitor your blood pressure and heart rate regularly.' Atenolol is a beta-blocker used to treat hypertension and other cardiovascular conditions. Patients should monitor their blood pressure and heart rate regularly to assess the medication's effectiveness and check for adverse effects like bradycardia or hypotension. Choice A is incorrect because Atenolol should not be taken with grapefruit juice, which can interfere with its absorption. Choice C is incorrect because Atenolol typically causes a decrease in heart rate, not a rapid heart rate. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Atenolol.
What should you monitor when administering Clopidogrel to a patient?
- A. Signs of thrombotic thrombocytopenic purpura
- B. Bleeding during therapy
- C. CBC with differential and platelet count
- D. All of the above
Correct Answer: D
Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.