Correct Answer: D

Rationale: Dry mouth is a common adverse effect of duloxetine, an SNRI, due to its anticholinergic properties, and should be monitored to ensure client comfort and hydration.
Choice A is incorrect because duloxetine is more likely to cause weight gain or be weight-neutral, not weight loss.
Choice B is incorrect because hypotension is not a frequent side effect; orthostatic hypotension may occur but is less common.
Choice C is incorrect because tachycardia is not a primary side effect; it may occur with overdose or serotonin syndrome.

Correct Answer: A

Rationale: Taking omeprazole 30 minutes before breakfast optimizes its acid-suppressing effect by aligning with the body's natural acid production cycle, improving GERD symptom control.
Choice B is incorrect because omeprazole may take several days to provide significant relief, not immediate relief.
Choice C is incorrect because, while swallowing the capsule whole is correct for delayed-release formulations, the timing (before meals) is more critical to emphasize for efficacy.
Choice D is incorrect because taking omeprazole with an antacid is not recommended, as it may reduce the drug's effectiveness; antacids are used for immediate relief, not in combination with proton pump inhibitors.

Correct Answer: D

Rationale: Tremors in the hands are a side effect of albuterol, a beta-2 agonist, due to its stimulatory effects on the nervous system, and should be reported to the provider, as it may require dose adjustment or an alternative medication.
Choice A is wrong because a heart rate of 110/min is within the expected range for albuterol, which can cause tachycardia, and is not immediately concerning unless sustained or accompanied by other symptoms.
Choice B is wrong because a respiratory rate of 20/min is normal (12-20/min) and expected in COPD, especially during treatment.
Choice C is wrong because an oxygen saturation of 95% is within the normal range (95-100%) and indicates adequate oxygenation.

Correct Answer: A

Rationale: Increasing fluid intake to 2 to 3 liters daily helps prevent uric acid crystal formation in the kidneys and promotes excretion, reducing gout flare-ups while taking allopurinol.
Choice B is incorrect because high-purine meals (e.g., red meat, shellfish) should be avoided, as they increase uric acid levels, counteracting allopurinol's effect.
Choice C is incorrect because allopurinol takes weeks to reduce uric acid levels and does not provide immediate joint pain relief; acute attacks require other treatments like NSAIDs.
Choice D is incorrect because, while ice may help during an acute gout attack, it is not directly related to allopurinol use and is not the priority instruction.

Correct Answer: C

Rationale: Storing expressed milk in the refrigerator for up to 4 days is correct, as breast milk can be safely stored in a refrigerator (at 4°C or 39°F) for up to 4 days to maintain its quality and safety for the newborn.
Choice A is wrong because newborns should be fed every 2-3 hours (8-12 times in 24 hours) or on demand, not every 4-5 hours, to ensure adequate nutrition and stimulate milk production.
Choice B is wrong because limiting feedings to 10 minutes per breast may not allow the newborn to receive sufficient milk, especially hindmilk; feedings should continue until the newborn is satisfied (typically 10-20 minutes per side).
Choice D is wrong because supplementing with formula after each breastfeeding session is not routinely recommended, as it can reduce milk supply and interfere with establishing breastfeeding; supplementation should only be used if medically indicated.