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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Determine what time the dose is taken: Dextroamphetamine-amphetamine is a stimulant that can interfere with sleep if taken too late in the day. The timing of the dose is crucial because early morning dosing minimizes insomnia, making this the most important initial assessment.

B. Ask about the client's bedtime routine: While bedtime routines can influence sleep quality, stimulant medication timing has a much stronger direct effect on insomnia, making this a secondary consideration after reviewing dose timing.

C. Inquire about perceived anxiety: Anxiety can contribute to sleep difficulties, but in clients taking stimulants, medication effects are a more likely cause. Addressing medication-related factors takes priority over psychological causes in this case.

D. Determine daily caffeine intake: Caffeine may worsen insomnia, but stimulant medications are generally a stronger factor in causing sleep disturbances. Assessing caffeine use is important but not the first priority compared to reviewing medication timing.

A. Notify the healthcare provider. B. Administer the medication. C. Hold the medication until the meal trays arrive. D. Obtain another finger stick blood glucose level.

Correct Answer is C

Explanation

A. Notify the healthcare provider: Notification of the healthcare provider is not immediately necessary just because of a meal delay. The nurse can manage the situation appropriately by adjusting the medication timing to ensure patient safety without requiring immediate provider involvement.

B. Administer the medication: Acarbose should be taken with the first bite of food to effectively delay carbohydrate absorption. Administering it without food available increases the risk of hypoglycemia, especially since the glucose level is already slightly elevated but within a manageable range.

C. Hold the medication until the meal trays arrive: Acarbose must be taken with the first mouthful of food to match the timing of glucose absorption. Holding the medication until the meal arrives ensures optimal therapeutic effect and prevents unnecessary hypoglycemia.

D. Obtain another finger stick blood glucose level: Rechecking the blood glucose is unnecessary at this time. The primary concern is coordinating the medication with food intake, not monitoring glucose trends over a short 30-minute delay.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is C

Explanation

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