A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse include in the teaching plan?

Correct Answer: C

Rationale: Clients taking metformin (Glucophage) should avoid alcohol as it can increase the risk of lactic acidosis. Metformin should be taken with meals to reduce gastrointestinal upset. While hypoglycemia is less common with metformin compared to other diabetes medications, clients should still be aware of its symptoms.

Correct Answer: B

Rationale: The correct instruction the nurse should include in the teaching plan for a client prescribed glipizide (Glucotrol) is to monitor for signs of hypoglycemia. Glipizide stimulates insulin release from the pancreas, which can lead to hypoglycemia. It is usually taken before a meal, not necessarily on an empty stomach. Alcohol consumption should be avoided to prevent interactions with the medication. Taking the medication before bedtime is not the typical recommendation.

Correct Answer: B

Rationale: In pharmacology, understanding therapeutic drug ranges is crucial for safe and effective medication management. For phenytoin (Dilantin), the therapeutic serum drug range is typically 10 to 20 mcg/mL. This range is established based on clinical trials and research indicating optimal seizure control with minimal side effects within this specific concentration in the blood. Option A (5 to 10 mcg/mL) is too low to provide adequate seizure control, while options C (20 to 30 mcg/mL) and D (30 to 40 mcg/mL) pose a higher risk of toxicity without significant added benefit in seizure management. Educationally, knowing the correct therapeutic range for medications like phenytoin is essential for nurses and healthcare providers to ensure patient safety and efficacy of treatment. It highlights the importance of monitoring drug levels to maintain therapeutic effects while minimizing adverse reactions. Understanding these principles can help prevent medication errors and improve patient outcomes in clinical practice.

Correct Answer: B

Rationale: Before administering amlodipine, it is important to check the client's blood pressure and heart rate. Amlodipine is known to lower blood pressure and heart rate as part of its mechanism of action. Monitoring these vital signs helps ensure the safety of the client and allows for appropriate assessment of the medication's effects post-administration.

Correct Answer: A

Rationale: In this scenario, option A, "I can skip a dose once a week," is the correct answer that indicates a need for further teaching. Lisinopril is an antihypertensive medication that needs to be taken consistently to effectively control blood pressure. Skipping doses can lead to a sudden increase in blood pressure, putting the client at risk for complications such as stroke or heart attack. Option B, "I need to change my position slowly," is an important instruction related to lisinopril as it can cause orthostatic hypotension, but this statement does not indicate a need for further teaching. Option C, "I take the pill after breakfast each day," is a suitable timing instruction for lisinopril, as it is often recommended to be taken at the same time each day with or without food. Option D, "If I get a bad headache, I should call my doctor immediately," is also a crucial instruction as severe headaches can be a sign of elevated blood pressure or other serious side effects of lisinopril. From an educational perspective, this question highlights the importance of medication adherence and understanding the implications of missing doses when managing chronic conditions like hypertension. Reinforcing the significance of consistent medication intake and addressing misconceptions can help prevent adverse outcomes and promote optimal health outcomes for patients.