A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements should the nurse include?

Correct Answer: B

Rationale: The correct answer is B: 'Report any signs of bleeding.' When a patient is prescribed warfarin, it is essential to monitor for signs of bleeding as warfarin is an anticoagulant that increases the risk of bleeding. Choices A, C, and D are incorrect. Avoid using a soft toothbrush is not directly related to warfarin therapy, increasing the intake of leafy green vegetables can interfere with warfarin's effectiveness due to its vitamin K content, and taking warfarin with food is unnecessary as it can be taken with or without food.

Correct Answer: D

Rationale: The correct answer is D: Persistent cough. Enalapril, an ACE inhibitor, is known to commonly cause a persistent cough as an adverse effect due to its effect on bradykinin levels. Clients should be instructed to monitor for a persistent cough and report it promptly to their healthcare provider for further evaluation and possible medication adjustment. Choices A, B, and C are incorrect as they are not commonly associated with enalapril use and are not typical adverse effects of ACE inhibitors.

Correct Answer: C

Rationale: Bradykinesia is a cardinal symptom of Parkinson's disease characterized by slowness of movement. An increase in bradykinesia may indicate a decline in the client's condition and the need for adjustments in their medication regimen. Therefore, the healthcare professional should promptly report this finding to the provider for further evaluation and management. Choices A, B, and D are not directly related to the client's Parkinson's disease or the medication levodopa/carbidopa. Dry mouth is a common side effect of many medications, including anticholinergics, but not specifically levodopa/carbidopa. Urinary retention and dizziness are also not typically associated with levodopa/carbidopa use for Parkinson's disease.

Correct Answer: C

Rationale: Increasing folic acid intake is crucial when taking methotrexate because the medication can lead to folic acid deficiency. Folic acid supplementation helps counteract this deficiency and reduces the risk of adverse effects associated with methotrexate therapy. Choices A, B, and D are incorrect. Avoiding dairy products is not specifically necessary for methotrexate therapy. Methotrexate is usually taken with food to reduce gastrointestinal side effects, so taking it on an empty stomach is not recommended. Monitoring for signs of hyperglycemia is not directly related to methotrexate use.

Correct Answer: B

Rationale: The correct answer is B. Sexual dysfunction is a common side effect of sertraline. When the client mentions this potential side effect, it indicates an understanding of the teaching about the medication's effects. This response shows awareness of a significant adverse effect that the client should be informed about when starting sertraline. Choices A, C, and D are incorrect because taking sertraline at bedtime, avoiding grapefruit juice, or experiencing weight loss are not key teaching points associated with this medication.

Correct Answer: D

Rationale: The correct answer is D: Dizziness. Dizziness is a sign of hypotension, a potential adverse effect of enalapril. Enalapril is an ACE inhibitor commonly prescribed for hypertension. Hypotension is a serious side effect that can lead to complications such as falls and injuries. Reporting dizziness promptly is crucial to prevent any harm to the client. Choices A, B, and C are not directly associated with enalapril use and are less concerning compared to the potential implications of hypotension indicated by dizziness.

Correct Answer: B

Rationale: Increasing fluid intake is essential when taking allopurinol to prevent the formation of kidney stones. Allopurinol can increase the levels of uric acid in the body, which can lead to kidney stone formation. By increasing fluid intake, the client can help flush out excess uric acid and prevent the development of kidney stones. It is important to drink plenty of water throughout the day to maintain adequate hydration and reduce the risk of kidney stone formation. Choices A, C, and D are incorrect. Taking allopurinol with food or in the morning does not specifically relate to preventing kidney stone formation. Avoiding dairy products is not a standard recommendation when taking allopurinol.

Correct Answer: D

Rationale: Instructing the client to take nitroglycerin at the first sign of chest pain is crucial for immediate relief of angina symptoms. Nitroglycerin is a fast-acting medication that helps dilate blood vessels, improving blood flow to the heart muscle. Therefore, prompt administration at the onset of chest pain is essential to alleviate anginal episodes effectively. Choices A, B, and C are incorrect because storing the medication properly, taking it as directed, or before meals are not specific instructions for managing acute anginal episodes, which require immediate action for symptom relief.

Correct Answer: B

Rationale: The correct answer is B. Avoiding alcohol is crucial in managing peptic ulcer disease as it helps prevent irritation and further damage to the stomach lining. Alcohol can worsen symptoms and hinder the healing process in individuals with this condition. Choice A is incorrect because NSAIDs can worsen peptic ulcers by irritating the stomach lining. Choice C is a correct dietary recommendation for managing peptic ulcer disease as it helps reduce stomach acid secretion and promotes healing. Choice D is incorrect as milk may temporarily soothe ulcer pain, but it can stimulate acid production and worsen symptoms in the long run.