A) Correct. Medication reconciliation is a process that helps prevent medication errors by ensuring that the client receives the correct medications at the correct doses and times.

B) Correct. Medication reconciliation involves comparing the client's current medications with their previous ones to identify any discrepancies or changes.

C) Correct. Medication reconciliation should be done at every transition of care, such as admission, transfer, or discharge, to ensure continuity and safety of medication therapy.

D) Correct. Medication reconciliation requires the client to keep an updated list of all their medications, including prescription, over-the-counter, herbal, and dietary supplements, and to share it with their health care providers.

E) Incorrect. Medication reconciliation does not allow the client to adjust their medication doses as needed. The client should always follow the prescribed instructions and consult their health care provider before making any changes.

A) Incorrect. The nurse should not instruct the client to stop taking both medications immediately without consulting the client's primary care provider. Abruptly discontinuing some medications can cause adverse effects or withdrawal symptoms.

B) Correct. The nurse should assess the client for signs of gastrointestinal bleeding, such as abdominal pain, black or tarry stools, or coffee-ground emesis. Ibuprofen and naproxen are both nonsteroidal anti-inflammatory drugs (NSAIDs) that can increase the risk of gastrointestinal bleeding when taken together or for a long time.

C) Incorrect. The nurse should document the finding in the client's medical record after assessing the client and notifying the primary care provider. Documentation is an important but not a priority action in this situation.

D) Incorrect. The nurse should notify the client's primary care provider after assessing the client for signs of gastrointestinal bleeding. The primary care provider may need to adjust or change the client's medication regimen to prevent further complications.

A) Correct. The client should use an electric razor when shaving to reduce the risk of bleeding from minor cuts or nicks. Warfarin is an anticoagulant that inhibits blood clotting and increases the bleeding time.

B) Incorrect. The client should not eat more green leafy vegetables to prevent bleeding. Green leafy vegetables are high in vitamin K, which antagonizes the effect of warfarin and reduces its anticoagulant activity.

C) Incorrect. The client should not take an extra dose if they miss one. Taking an extra dose can cause excessive anticoagulation and increase the risk of bleeding or hemorrhage.

D) Incorrect. The client should not check their blood pressure every day unless instructed by their health care provider. Checking blood pressure every day is not related to warfarin therapy and may cause unnecessary anxiety or confusion.

A) Correct. The nurse should discontinue the IV line and start a new one in another site. The IV site is showing signs of phlebitis, which is inflammation of the vein caused by mechanical, chemical, or bacterial irritation. Phlebitis can lead to complications such as thrombophlebitis, infection, or extravasation.

B) Correct. The nurse should apply a warm compress to the IV site to promote vasodilation and blood flow, which can help reduce inflammation and pain.

C) Correct. The nurse should elevate the affected extremity on a pillow to facilitate venous return and decrease edema.

D) Incorrect. The nurse should not administer an antihistamine to the client unless prescribed by the health care provider. Antihistamines are used to treat allergic reactions, not phlebitis.

E) Incorrect. The nurse should not flush the IV line with normal saline. Flushing the IV line can worsen the inflammation and increase the risk of infection or thrombus formation.

A) Incorrect. The nurse should instruct the client to store unopened insulin vials in the refrigerator, not in the freezer. Freezing can damage the insulin and make it ineffective.

B) Correct. The nurse should instruct the client to rotate injection sites within the same anatomical region, such as the abdomen, thighs, arms, or buttocks. Rotating injection sites can prevent lipodystrophy, which is a disorder of fat metabolism that causes hypertrophy or atrophy of subcutaneous tissue.

C) Incorrect. The nurse should instruct the client not to mix short-acting and long-acting insulins in the same syringe. Mixing different types of insulins can alter their onset, peak, and duration of action and affect blood glucose control.

D) Correct. The nurse should instruct the client to draw up regular insulin before NPH insulin when mixing them in the same syringe. This can prevent contamination of the regular insulin vial with NPH insulin, which can affect its potency and clarity.

A) Correct. The client should shake the inhaler well before use to mix the medication and propellant evenly and ensure proper dosage delivery.

B) Incorrect. The client should hold their breath for 10 seconds after inhaling to allow the medication to reach the lower airways and improve bronchodilation.

C) Incorrect. The client should exhale fully after placing the mouthpiece in their mouth and closing their lips around it. This can prevent wasting of medication and ensure optimal inhalation.

D) Incorrect. The client should repeat the puff after 1 minute if needed or prescribed. Waiting for 1 minute between puffs can allow enough time for the first puff to take effect and reduce adverse effects such as tachycardia or tremors.

A) Correct. The nurse should include reducing sodium intake to less than 2 g per day in the teaching. Sodium can increase fluid retention and blood volume, which can raise blood pressure.

B) Correct. The nurse should include increasing physical activity to at least 30 minutes per day in the teaching. Physical activity can lower blood pressure by strengthening the heart, improving blood circulation, and reducing body weight.

C) Correct. Limiting alcohol consumption to no more than two drinks per day for men and one drink per day for women. Excessive alcohol consumption can raise blood pressure, so moderation is important.

D) Correct. Quitting smoking and avoiding exposure to secondhand smoke. Smoking and exposure to secondhand smoke are significant risk factors for hypertension and other cardiovascular diseases.

E) Incorrect. Taking a nap for 20 minutes every afternoon. While rest and relaxation are important for overall well-being, taking a nap specifically for 20 minutes every afternoon may not be directly related to lowering blood pressure. It's better to focus on the other lifestyle modifications mentioned above.