A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

Correct Answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of this medication. Verapamil is a calcium channel blocker used to treat hypertension, and dietary fiber helps maintain bowel regularity and prevent constipation that may occur as a side effect of the medication.

Correct Answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.

Correct Answer: A

Rationale: In pharmacology education, it is crucial to understand the rationale behind medication instructions to ensure safe and effective treatment. For the question regarding starting Simvastatin, the correct answer is A) Take this medication in the evening. This instruction is important because Simvastatin is typically more effective when taken in the evening since cholesterol synthesis peaks at night. Option B) Change positions slowly when rising from a chair is not directly related to Simvastatin but is a general precaution for medications that may cause orthostatic hypotension. Option C) Maintain a steady intake of green leafy vegetables is not relevant to Simvastatin but is important for medications like Warfarin which interact with Vitamin K. Option D) Consume no more than 1 L/day of fluid is not a specific requirement for Simvastatin but is more relevant for medications that require fluid restriction like Lithium. Educationally, understanding the timing of medication administration is crucial for optimal drug efficacy. Teaching this specific detail ensures that the medication can achieve its intended therapeutic effect. This question highlights the importance of individualized medication education based on the pharmacokinetics and pharmacodynamics of each drug.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Protamine. Protamine is the specific antidote for heparin, a common anticoagulant medication. Heparin works by inhibiting the activity of clotting factors, which can lead to bleeding complications. Protamine works by binding to heparin, neutralizing its anticoagulant effects, and thus reversing its potential for causing bleeding. A) Vitamin K1 is used to reverse the effects of warfarin, another type of anticoagulant that works differently from heparin. It is not the appropriate antidote for heparin-induced bleeding. B) Atropine is used to treat bradycardia or certain types of poisoning. It is not indicated for heparin-induced bleeding. D) Calcium gluconate is used to treat conditions like hypocalcemia or to counteract the effects of calcium channel blocker overdose. It is not the antidote for heparin-induced bleeding. In an educational context, understanding antidotes for common medications is crucial for nursing practice to ensure patient safety and appropriate intervention in case of adverse drug reactions. Nurses need to be knowledgeable about antidotes specific to different medications to provide timely and effective care to their patients.

Correct Answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.