Correct Answer: B

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each day, usually at bedtime, to prevent tolerance. The client should then apply a new patch the next morning. This practice helps maintain the effectiveness of the medication and prevents the body from becoming accustomed to the continuous presence of nitroglycerin.

Correct Answer: B

Rationale: Avoiding grapefruit juice is crucial when taking Simvastatin because grapefruit juice can increase the blood levels of the medication. This elevation in drug levels can potentiate the side effects of Simvastatin, such as muscle pain and liver damage. It is essential for the client to be aware of this interaction to prevent potential harm and ensure the effectiveness of the medication.

Correct Answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by interacting with its metabolism. While garlic and ginseng are also known to interact with Warfarin, the specific supplement the nurse should instruct the client to avoid in this scenario is St. John's wort.

Correct Answer: B

Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors, such as enalapril. This cough can be bothersome and may indicate the need for a medication adjustment. It is crucial for the client to report this symptom to their healthcare provider to explore potential alternatives or adjustments to the treatment plan.

Correct Answer: D

Rationale: Anorexia, blurred vision, stomach pain, and diarrhea are common manifestations of digoxin toxicity. Patients should be advised to report these symptoms promptly to their healthcare provider for further evaluation and management.