A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?
"The extra letters after the name of the medication mean it is a stronger dose."
"I will not have to do anything different because it is the same medication."
"Now I will not have to diet to lose weight."
"With the new medication, I should experience fewer side effects."
The Correct Answer is D
Choice A reason: The extra letters after the name of the medication do not mean it is a stronger dose, but that it is a combination of two different medications. Metoprolol is a beta-blocker that lowers blood pressure and heart rate, while hydrochlorothiazide is a diuretic that reduces fluid retention and blood volume. The combination of these two medications may have a synergistic effect and lower blood pressure more effectively than either one alone.
Choice B reason: The client will have to do some things differently because it is not the same medication, but a combination of two medications. The client will have to monitor their blood pressure, weight, fluid intake, and electrolyte levels more closely, as the addition of hydrochlorothiazide may increase the risk of dehydration, hypotension, and hypokalemia. The client will also have to avoid alcohol, salt, and potassium supplements, as they may interact with the medication and affect its efficacy or safety.
Choice C reason: The client will still have to diet to lose weight, as the medication does not cause weight loss, but may cause weight gain due to fluid retention. The client will have to follow a healthy diet that is low in sodium, fat, and cholesterol, as these may worsen hypertension and increase the risk of cardiovascular complications. The client will also have to exercise regularly, as this may help lower blood pressure and improve overall health.
Choice D reason: The client may experience fewer side effects with the new medication, as the combination of metoprolol and hydrochlorothiazide may lower the dose and frequency of each medication, and reduce the adverse effects of each one. For example, metoprolol may cause fatigue, dizziness, or bradycardia, while hydrochlorothiazide may cause dry mouth, headache, or gout. The combination of these two medications may balance out these effects and improve the client's tolerance and compliance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Giving the medication in the morning daily is a correct instruction, as it helps to prevent asthma attacks throughout the day and night. Montelukast is a leukotriene receptor antagonist that blocks the inflammatory response and bronchoconstriction caused by leukotrienes. Montelukast has a long duration of action and can be given once a day, preferably in the evening or at bedtime. However, for children who have exercise-induced asthma, the medication can be given in the morning to prevent exercise-induced bronchospasm.
Choice B reason: Administering the granules mixed with 20 oz of water is not a correct instruction, as it may reduce the absorption and effectiveness of the medication. Montelukast granules should be administered within 15 minutes of opening the packet and can be mixed with a small amount of soft food, such as applesauce, mashed carrots, or ice cream. The granules should not be mixed with liquids, such as water, juice, or milk, as they may dissolve and lose their potency.
Choice C reason: Giving the medication at the onset of wheezing is not a correct instruction, as it may not provide immediate relief of the symptoms and may delay the use of a rescue inhaler. Montelukast is not a bronchodilator and does not work quickly to open the airways. Montelukast is a preventive medication that should be taken regularly to reduce the frequency and severity of asthma attacks. The child should use a short-acting beta-agonist, such as albuterol, for the quick relief of wheezing.
Choice D reason: Administering the medication 2 hr before exercise is not a correct instruction, as it may not prevent exercise-induced bronchospasm and may interfere with the daily dosing schedule. Montelukast should be taken once a day, preferably in the evening or at bedtime, to provide consistent protection against asthma triggers. However, for children who have exercise-induced asthma, the medication can be given in the morning to prevent exercise-induced bronchospasm. The child should also use a short-acting beta-agonist before exercise, as needed.
Correct Answer is D
Explanation
The correct answer is: d. The client uses garlic to lower cholesterol levels.
Choice A: The client follows a low-fat diet to reduce cholesterol
Following a low-fat diet to reduce cholesterol does not have a significant impact on the effects of warfarin. While diet can influence overall health and cholesterol levels, it does not directly interact with warfarin’s anticoagulant properties.
Choice B: The client drinks a glass of grapefruit juice every day
Grapefruit juice is known to interact with various medications by inhibiting the cytochrome P450 enzymes, particularly CYP3A4. However, grapefruit juice does not significantly affect warfarin metabolism. It is more commonly associated with interactions with statins and other medications.
Choice C: The client sprinkles flax seeds on food 1 hr before taking the anticoagulant
Flax seeds are rich in omega-3 fatty acids and fiber, which can be beneficial for heart health. However, there is no strong evidence to suggest that flax seeds significantly potentiate the effects of warfarin. They do not have a direct interaction with the anticoagulant properties of warfarin.
Choice D: The client uses garlic to lower cholesterol levels
Garlic is known to have antiplatelet properties, which can enhance the anticoagulant effects of warfarin. This can increase the risk of bleeding in clients taking warfarin. Garlic can interfere with the blood clotting process, making it a significant factor to consider when managing a client on warfarin.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.