The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The nurse evaluates the need for further teaching when the client states which of the following?

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.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Tremors. This is because levothyroxine is a medication used to treat hypothyroidism by replacing or providing more thyroid hormone. When a client taking levothyroxine experiences tremors, it can indicate that the dosage may be too high, leading to symptoms of hyperthyroidism. Option A) Fatigue, is a common symptom of hypothyroidism, which levothyroxine is prescribed to alleviate. Therefore, fatigue would not necessarily indicate a need to notify the healthcare provider. Option C) Cold intolerance is also a symptom of hypothyroidism that should improve with levothyroxine treatment. Experiencing cold intolerance may not be a direct indication of a medication issue. Option D) Excessively dry skin is a symptom of hypothyroidism that should improve with levothyroxine therapy. It is not typically associated with a need to notify the healthcare provider. Educationally, it is important for nurses and clients to understand the side effects and expected outcomes of medications. Teaching clients to recognize and report specific symptoms like tremors can help prevent complications and ensure optimal medication management. Regular monitoring and communication with the healthcare provider are essential in managing medication therapies effectively.

Correct Answer: C

Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Nausea and vomiting. Trimethobenzamide (Tigan) is an antiemetic medication commonly used to treat nausea and vomiting. By monitoring the client for relief of nausea and vomiting, the nurse can assess the effectiveness of the medication in managing these symptoms. Option A) Heartburn is incorrect because trimethobenzamide is not indicated for the treatment of heartburn. It specifically targets nausea and vomiting. Option B) Constipation is incorrect because trimethobenzamide is not known to relieve constipation. This medication does not affect bowel motility or constipation symptoms. Option C) Abdominal pain is incorrect because while trimethobenzamide may indirectly alleviate abdominal pain associated with nausea and vomiting, it is not the primary symptom targeted by this medication. Educationally, understanding the specific indications of medications like trimethobenzamide is crucial for nurses to provide safe and effective care to their patients. By knowing the intended effects of a drug, nurses can accurately assess patient responses and intervene appropriately. This knowledge also helps prevent medication errors and ensures optimal patient outcomes.

Correct Answer: B

Rationale: The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.