A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

Correct Answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This is essential to prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can lead to the body becoming less responsive to its therapeutic effects over time, making it less effective in managing the condition it is prescribed for.

Correct Answer: C

Rationale: In this scenario, the correct laboratory result to review for an indication of a therapeutic effect of epoetin alfa in a client with chronic renal disease is the hematocrit (Hct). Epoetin alfa is a medication that stimulates red blood cell production, and an increase in the hematocrit level indicates a positive response to the treatment. Option A, the leukocyte count, is not relevant in this context as it measures white blood cells, which are not directly affected by epoetin alfa therapy. Option B, the platelet count, is also unrelated to the medication's therapeutic effect on red blood cell production. Option D, the erythrocyte sedimentation rate (ESR), is a nonspecific indicator of inflammation and not specifically related to the action of epoetin alfa in stimulating erythropoiesis. Understanding the rationale behind monitoring specific laboratory values in response to pharmacological interventions is crucial in nursing practice. By recognizing the significance of changes in hematocrit levels with epoetin alfa therapy, nurses can effectively evaluate the medication's efficacy and adjust treatment as needed to optimize patient outcomes in clients with chronic renal disease.

Correct Answer: D

Rationale: Clients prescribed furosemide are at risk for orthostatic hypotension, a sudden drop in blood pressure when changing positions. Advising the client to stand up slowly can help prevent this complication. Instructing the client to avoid rapid position changes decreases the likelihood of dizziness or fainting episodes.

Correct Answer: D

Rationale: The correct laboratory test to monitor the therapeutic effect of warfarin is the PT/INR. Warfarin affects blood clotting, and the PT/INR levels indicate the effectiveness of the medication in preventing clot formation. Therefore, monitoring PT/INR levels helps ensure that the client is within the therapeutic range and is protected from potential complications related to clotting.

Correct Answer: C

Rationale: In the context of pharmacology, the correct answer for a client starting a new prescription for ferrous sulfate is option C: Take the medication with orange juice to enhance absorption. Ferrous sulfate is an iron supplement commonly prescribed to treat or prevent iron deficiency anemia. Orange juice, or other sources of vitamin C, can help enhance the absorption of iron due to its acidic nature, which aids in converting iron into a more absorbable form. Option A, taking the medication with meals, is not ideal for ferrous sulfate as it may decrease absorption due to interactions with food components like calcium and tannins. Option B, taking the medication on an empty stomach, might cause gastrointestinal upset in some individuals. Option D, taking the medication with a full glass of milk, is incorrect because calcium in milk can interfere with the absorption of iron. Educationally, it is crucial for nurses and healthcare professionals to understand the impact of food and beverages on medication absorption to ensure optimal therapeutic outcomes for their patients. Providing accurate instructions on how to take medications can significantly influence treatment effectiveness and patient compliance.