A client is prescribed furosemide. Which of the following instructions should the nurse include in the teaching?

Correct Answer: A

Rationale: The correct instruction for a client prescribed furosemide is to take the medication in the morning. Furosemide, a diuretic, is best taken in the morning to prevent nocturia, which is excessive urination at night. Taking it earlier in the day can help reduce disruptions to sleep patterns. Therefore, advising the client to take furosemide in the morning is crucial for optimal therapeutic effects.

Correct Answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Offer oral hygiene every 2 hours. This is the most appropriate action for a client in labor receiving IV opioid analgesics because opioids can cause dry mouth as a side effect. Providing oral hygiene helps alleviate discomfort, maintain oral health, and enhance overall comfort for the client during labor. Option A) Instruct the client to self-ambulate every 2 hours is incorrect because opioid analgesics can cause drowsiness and impair coordination, making ambulation unsafe for the client. Option C) Anticipate medication administration 2 hours prior to delivery is incorrect because the timing of medication administration should be based on the client's pain level and not a predetermined time frame. Option D) Monitor fetal heart rate every 2 hours is incorrect because while fetal monitoring is essential during labor, monitoring the maternal vital signs and comfort measures take precedence over fetal heart rate monitoring in this context. Educationally, this question highlights the importance of understanding the effects of opioid analgesics on laboring clients and the appropriate nursing interventions to ensure their safety and comfort. It emphasizes the need for individualized care based on the client's condition and medication effects.

Correct Answer: C

Rationale: The correct answer is option C: "I'll let the doctor know if I develop sores in my mouth while taking this medication." This statement indicates understanding because one of the side effects of Methotrexate is mucosal ulceration, which can manifest as sores in the mouth. By recognizing and reporting this side effect to the healthcare provider, the client can receive appropriate management and potentially prevent further complications. Option A is incorrect because the frequency of blood monitoring for Methotrexate is more frequent than once a year due to its potential for adverse effects on the bone marrow, liver, and kidneys. Option B is incorrect because Methotrexate is usually taken with food to reduce gastrointestinal side effects. Option D is incorrect because Methotrexate does not interact with oral contraceptives, so there is no need to stop taking them while on Methotrexate therapy. In an educational context, it is crucial for nurses to ensure that clients understand the side effects and monitoring requirements of medications like Methotrexate to promote safe and effective treatment. Teaching clients about potential side effects and when to seek medical attention empowers them to take an active role in their healthcare and enhances medication adherence and safety.

Correct Answer: A

Rationale: The nurse should educate the client that taking Celecoxib increases the risk of a myocardial infarction due to its suppression of vasodilation. This medication belongs to the class of NSAIDs known to have cardiovascular risks, including an increased risk of heart attacks. Therefore, it is essential for the nurse to emphasize this potential adverse effect during client teaching to ensure the client is aware of the associated risks.