Patient education on medication purpose, dosage, and side effects

Total Questions : 7

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Question 1:

A nurse is teaching a client who has been prescribed warfarin for atrial fibrillation. Which of the following statements by the client indicates a need for further education?

Explanation

A) Incorrect. The client should not avoid eating foods that are high in vitamin K, such as leafy green vegetables, because they can interfere with the anticoagulant effect of warfarin. The client should maintain a consistent intake of vitamin K and follow a balanced diet.

B) Correct. The client should use a soft-bristled toothbrush to prevent bleeding from the gums, which can occur due to the increased risk of bleeding caused by warfarin. The client should also avoid using dental floss and electric razors.

C) Correct. The client should monitor their blood pressure regularly at home, as warfarin can affect blood pressure and increase the risk of stroke or bleeding complications. The client should report any abnormal readings to their provider.

D) Correct. The client should report any signs of bruising or bleeding to their provider, as they may indicate an adverse reaction to warfarin or an overdose. The client should also report any signs of infection, such as fever, sore throat, or pus, as they may increase the risk of bleeding.


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Question 2:

A nurse is teaching a client who has a new prescription for warfarin. Which of the following statements by the client indicates a need for further teaching?

Explanation

A) Incorrect. The client should eat a consistent amount of foods that are high in vitamin K, such as leafy greens, broccoli, and cabbage. Vitamin K can interfere with the anticoagulant effect of warfarin and increase the risk of clotting.

B) Correct. The client should use an electric razor for shaving to prevent cuts and bleeding.

C) Correct. The client should check their blood pressure regularly to monitor for hypertension, which can increase the risk of bleeding complications.

D) Correct. The client should report any signs of bleeding or bruising to their provider, as they may indicate a high INR level or a bleeding disorder.


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Question 3:

A client is prescribed metformin for type 2 diabetes mellitus. The nurse instructs the client to take the medication with meals. What is the rationale for this instruction?

Explanation

A) Incorrect. Metformin does not cause hypoglycemia, as it does not stimulate insulin secretion. It lowers blood glucose levels by decreasing hepatic glucose production and increasing insulin sensitivity.

B) Incorrect. Metformin absorption is not affected by food intake. The medication can be taken with or without food, but taking it with meals can help reduce gastrointestinal side effects.

C) Correct. Metformin can cause gastrointestinal upset, such as nausea, diarrhea, and abdominal pain. Taking it with meals can help minimize these effects by slowing down the transit of the medication through the digestive tract.

D) Incorrect. Metformin effectiveness is not influenced by food intake. The medication works by improving glucose metabolism and insulin action.


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Question 4:

A nurse is reviewing the medication list of a client who has bipolar disorder. The client is taking lithium carbonate, haloperidol, and lorazepam. The nurse should monitor the client for which of the following adverse effects?

Explanation

A) Incorrect. Extrapyramidal symptoms (EPS), such as dystonia, akathisia, and tardive dyskinesia, are caused by dopamine antagonists, such as haloperidol. However, these symptoms are not related to the combination of medications that the client is taking.

B) Incorrect. Serotonin syndrome is a potentially life-threatening condition that results from excessive serotonin activity in the central nervous system. It is caused by serotonin-enhancing medications, such as antidepressants, opioids, and triptans. None of the medications that the client is taking have this effect.

C) Correct. Neuroleptic malignant syndrome (NMS) is a rare but serious condition that occurs due to dopamine blockade in the brain and peripheral tissues. It is caused by antipsychotic medications, such as haloperidol. The risk of NMS is increased when lithium carbonate is added to antipsychotic therapy, as lithium can potentiate the dopamine-blocking effect of antipsychotics.

D) Incorrect. Lithium toxicity is a condition that occurs when lithium levels exceed the therapeutic range of 0.6 to 1.2 mEq/L. It is caused by factors that affect lithium excretion, such as dehydration, renal impairment, drug interactions, and overdose. None of the other medications that the client is taking interact with lithium or affect its excretion.


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Question 5:

A nurse is administering morphine sulfate intravenously to a client who has acute pain due to a kidney stone. Which of the following actions should the nurse take?

Explanation

A) Incorrect. Morphine sulfate does not need to be diluted in normal saline before administration. Diluting the medication can reduce its potency and effectiveness.

B) Correct. Morphine sulfate should be injected slowly over 1 to 2 minutes to prevent adverse effects, such as hypotension, respiratory depression, and nausea.

C) Incorrect. Heparin is not indicated for flushing the IV line before and after administration of morphine sulfate. Heparin is an anticoagulant that can increase the risk of bleeding. The IV line should be flushed with normal saline or sterile water to prevent medication incompatibility and ensure complete delivery of the medication.

D) Incorrect. The nurse should monitor the client's respiratory rate more frequently than every 15 minutes, as morphine sulfate can cause respiratory depression. The nurse should monitor the client's respiratory rate before, during, and after administration of the medication, and at least every 5 minutes until the client's pain is relieved.


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Question 6:

A client is receiving phenytoin for seizure prevention. The nurse should instruct the client to avoid which of the following over-the-counter medications while taking phenytoin?

Explanation

A) Incorrect. Acetaminophen is a non-opioid analgesic that can be used safely with phenytoin. However, the nurse should advise the client to limit their intake of acetaminophen to no more than 4 g per day, as higher doses can cause liver toxicity.

B) Incorrect. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can be used safely with phenytoin. However, the nurse should advise the client to monitor for signs of bleeding, such as bruising, petechiae, and hematuria, as NSAIDs can inhibit platelet aggregation and increase the risk of bleeding.

C) Incorrect. Diphenhydramine is an antihistamine that can be used safely with phenytoin. However, the nurse should advise the client to avoid driving or operating machinery while taking diphenhydramine, as it can cause drowsiness and impair mental alertness.

D) Correct. Ginkgo biloba is an herbal supplement that can interact with phenytoin and reduce its effectiveness. Ginkgo biloba can induce hepatic enzymes that increase the metabolism and clearance of phenytoin, leading to subtherapeutic levels and increased risk of seizures.


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Question 7:

A client is prescribed amoxicillin for a bacterial infection. The nurse should teach the client to report which of the following signs of an allergic reaction to the medication?

Explanation

A) Incorrect. Diarrhea is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to drink plenty of fluids and eat foods that are high in fiber to prevent dehydration and constipation. The nurse should also instruct the client to report severe or bloody diarrhea, as it may indicate a serious condition called pseudomembranous colitis.

B) Correct. Rash is a sign of an allergic reaction to amoxicillin, and it may indicate a hypersensitivity or anaphylactic reaction. The nurse should instruct the client to report any rash, itching, hives, or swelling to their provider immediately and stop taking the medication.

C) Incorrect. Headache is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to take over-the-counter analgesics, such as acetaminophen or ibuprofen, to relieve headache pain.

D) Incorrect. Nausea is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to take the medication with food or milk to reduce nausea and vomiting.


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