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

Correct Answer: B

Rationale: The correct instruction for the nurse to include is to 'Avoid consuming grapefruit juice.' Grapefruit juice can increase sertraline levels, leading to an elevated risk of side effects. Instructing the client to avoid grapefruit juice is crucial to prevent potential interactions that could impact the effectiveness and safety of the medication. The other options are not directly related to sertraline administration. Taking the medication in the morning may vary depending on individual preferences or the prescriber's directions. Taking the medication with a full glass of water is a general instruction for many medications and not specific to sertraline. Monitoring for signs of weight gain is important but not a direct instruction related to taking sertraline.

Correct Answer: D

Rationale: The correct answer is D: Respiratory depression. Hydrocodone is an opioid medication that can cause respiratory depression, a serious side effect that should be reported immediately to the healthcare provider. Constipation, sedation, and dry mouth are common side effects of hydrocodone but are not as concerning as respiratory depression. Constipation can be managed with lifestyle modifications and medications, sedation may improve with time or dosage adjustments, and dry mouth is a common and usually benign side effect.

Correct Answer: C

Rationale: Choice C is correct because off-label prescribing—using a drug for an unapproved indication—is legal if supported by scientific evidence and clinical judgment, common in practice. Choice A is incorrect as the FDA doesn't regulate off-label use, just approval. Choice B is wrong because it's not illegal for NPs; it's allowed with justification. Choice D is incorrect since the DEA oversees controlled substances, not off-label prescribing.

Correct Answer: B

Rationale: Choice B is correct because clozapine requires monitoring (e.g., ANC for neutropenia) under its REMS program due to severe risks, unlike others. Choice A is incorrect as acetaminophen doesn't need REMS monitoring. Choice C is wrong because ibuprofen lacks such requirements. Choice D is incorrect since only clozapine applies.

Correct Answer: B

Rationale: Choice B is correct because APRNs are trained to adopt a holistic approach, addressing physical, emotional, and social aspects of health, and often involve patients in care decisions, improving satisfaction and outcomes. Choice A is incorrect as it exaggerates pharmacology knowledge; APRNs study it extensively, but so do physicians, making superiority unproven. Choice C is wrong because APRNs' prescribing of narcotics varies by practice and isn't inherently less than others. Choice D is false since independent prescribing isn't universal—state laws differ, and some require oversight, similar to physician assistants.

Correct Answer: D

Rationale: The correct instruction to include in the discharge teaching for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator that helps relax blood vessels, increasing blood flow to the heart muscle and reducing the workload of the heart. Taking it at the onset of chest pain helps alleviate angina symptoms quickly and effectively. Storing the medication in a cool, dark place (Choice A) is not a critical instruction for this medication. Taking the medication at bedtime (Choice B) or on an empty stomach (Choice C) is not relevant to the administration of nitroglycerin for angina relief.

Correct Answer: B

Rationale: Choice B is correct because educating patients about expected adverse reactions prepares them to manage side effects and seek help if needed, enhancing safety and adherence. Choice A is incorrect as reading level should match the patient's, not a fixed standard. Choice C is wrong because storing leftovers encourages misuse—antibiotics should be completed. Choice D is incorrect since language should suit the patient, not always English.

Correct Answer: B

Rationale: The correct answer is B: Dry cough. A dry cough is a common side effect of enalapril that can indicate the development of angioedema or potentially life-threatening angioedema. An onset of dry cough should be reported to the provider promptly as it may require discontinuation of the medication to prevent further complications. Frequent urination, tremors, and dizziness are not typically associated with enalapril use and are less likely to be of immediate concern compared to a dry cough in this context.

Correct Answer: D

Rationale: Choice D is correct because acetaminophen (liver risk), aspirin (GI bleeding), and ibuprofen (ulcers, kidney issues) can all cause ADRs if misused, per safety data. Choice A is incorrect alone as it's one risk. Choice B is wrong by itself because aspirin is just part. Choice C is incorrect solo since ibuprofen is only one concern.