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When providing discharge instructions to a client with a new prescription for Lisinopril, which of the following instructions should the nurse include?
- A. Avoid salt substitutes.
- B. Take this medication at bedtime.
- C. Increase your intake of potassium-rich foods.
- D. Take this medication with food.
Correct Answer: A
Rationale: The correct answer is to instruct the client to avoid salt substitutes. Lisinopril, an ACE inhibitor, can lead to hyperkalemia, so it is essential to avoid salt substitutes containing potassium, which can further increase potassium levels in the body. This instruction aims to prevent potential adverse effects and ensure the client's safety while taking Lisinopril.
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A healthcare professional is preparing to administer Butorphanol to a client who has a history of substance use disorder. The healthcare professional should identify which of the following information as true regarding Butorphanol?
- A. Butorphanol has a lower risk for abuse than morphine.
- B. Butorphanol causes a lower incidence of respiratory depression than morphine.
- C. Butorphanol can be reversed with an opioid antagonist.
- D. Butorphanol can cause abstinence syndrome in opioid-dependent clients.
Correct Answer: D
Rationale: Butorphanol is an opioid agonist/antagonist that can precipitate withdrawal symptoms in opioid-dependent individuals. Symptoms of abstinence syndrome can include abdominal pain, fever, and anxiety. This occurs because butorphanol competes with and displaces opioid agonists from receptors, leading to withdrawal symptoms in opioid-dependent clients.
A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?
- A. Dry cough
- B. Weight gain
- C. Diarrhea
- D. Nausea
Correct Answer: A
Rationale: A persistent dry cough is a common adverse effect of Enalapril, which is an ACE inhibitor. Enalapril can cause the accumulation of bradykinin, leading to cough. If the client experiences a persistent dry cough, it is essential to notify the healthcare provider for further evaluation and possible medication adjustment.
A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?
- A. The client will start at a high dose, and the dose will be tapered as needed.
- B. The client will remain on the initial dosage during the course of treatment.
- C. The client's dosage will be adjusted daily based on blood levels.
- D. The client will start on a low dose, which will be gradually increased.
Correct Answer: D
Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes.
A client with prostate cancer is receiving leuprolide. Which of the following findings should the nurse monitor?
- A. Increased testosterone levels
- B. Increased libido
- C. Gynecomastia
- D. Hypoglycemia
Correct Answer: C
Rationale: The nurse should monitor the client for gynecomastia, as it is an adverse effect of leuprolide due to decreased testosterone levels. Leuprolide works by decreasing testosterone production, which can lead to gynecomastia, the development of male breast tissue. Monitoring for this side effect is essential for early detection and intervention.
An adolescent client has a new prescription for Clomipramine for OC. Which of the following instructions should the nurse include to minimize an adverse effect of this medication?
- A. Wear sunglasses when outdoors.
- B. Check your temperature daily.
- C. Take this medication in the morning.
- D. Add extra calories to your diet.
Correct Answer: A
Rationale: To minimize the adverse effect of photophobia associated with Clomipramine, the client should be advised to wear sunglasses when outdoors. Clomipramine is a tricyclic antidepressant (TCA) known to cause anticholinergic effects like photophobia, which can be reduced by protecting the eyes with sunglasses when exposed to bright light.