An older adult client is being discharged after a myocardial infarction (MI) and receives a new prescription for atenolol. Which instruction is most important for the nurse to include in this client's teaching plan?
Avoid driving or operating machinery.
Take a missed dose as soon as possible.
Standing slowly when getting up from bed.
Avoid intake of alcoholic beverages.
The Correct Answer is C
A. Avoid driving or operating machinery: Drowsiness and dizziness can occur with atenolol, especially when initiating therapy, but these effects are usually mild. While it's reasonable to use caution initially, this is not the most critical teaching point compared to orthostatic safety.
B. Take a missed dose as soon as possible: Although this may seem helpful, patients should not double doses or take extra doses close together. If a significant amount of time has passed, the missed dose may need to be skipped to prevent bradycardia or hypotension.
C. Standing slowly when getting up from bed: Atenolol, a beta-blocker, can cause orthostatic hypotension, especially in older adults. Teaching the client to rise slowly helps reduce the risk of dizziness and falls, making this a high-priority safety instruction following discharge.
D. Avoid intake of alcoholic beverages: Alcohol may enhance the hypotensive effects of beta-blockers, but moderate consumption is not strictly contraindicated. This advice is relevant but less urgent than preventing injury from orthostatic hypotension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Ask the client to describe her dietary intake history for the last several days: Orlistat works by inhibiting fat absorption, and excessive intake of dietary fats can cause oily stools and gas. Assessing the client’s recent diet helps determine if her symptoms are due to high fat consumption, which can then be managed through dietary adjustments.
B. Instruct the client to increase her intake of saturated fats over the next week: Increasing fat intake would likely worsen her symptoms, as orlistat prevents fat absorption, leading to more pronounced gastrointestinal side effects if fat intake remains high.
C. Advise the client to stop taking the drug and contact her healthcare provider (HCP): Stopping orlistat is unnecessary at this stage. Oily stools are a common and expected side effect if dietary fat intake is not controlled, so addressing dietary habits is the first and more appropriate intervention.
D. Obtain a stool specimen to evaluate for occult blood and fat content: There is no indication that the client’s symptoms suggest gastrointestinal bleeding. The oily stools are an anticipated effect of fat malabsorption caused by orlistat, not a sign of occult blood loss.
Correct Answer is D
Explanation
A. Monitor urinary output: While monitoring output is important, it does not provide immediate diagnostic information regarding the cause of the client’s thirst. It is a supportive action but not the most efficient first step to investigate potential hyperglycemia.
B. Notify the healthcare provider (HCP): Notifying the HCP is appropriate if there are abnormal findings or the client’s condition worsens. However, the nurse should gather objective data—such as a blood glucose reading—before contacting the provider.
C. Prepare to give insulin: Insulin should not be administered without confirmation of elevated blood glucose. Giving insulin without verifying hyperglycemia could lead to serious complications, including hypoglycemia.
D. Obtain fingerstick blood glucose: Methylprednisolone, a corticosteroid, can raise blood glucose levels, and excessive thirst is a classic symptom of hyperglycemia. Checking the client’s blood glucose is the most appropriate first action to determine if elevated glucose is causing the symptom.
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