The nurse is providing discharge instructions to a client who is prescribed lisinopril, an ACE inhibitor. Which statement by the client demonstrates proper understanding of the discharge instructions?

I will review the ingredients before using salt substitutes.

If I feel unwell, it is okay that I miss a dose.

It is okay if I feel dizzy when I stand after sitting for a while.

It is okay to incorporate an unlimited amount of potatoes, bananas, and oranges in my diet.

Answer and Explanation

The Correct Answer is A

Choice A reason: Lisinopril can cause hyperkalemia due to reduced potassium excretion. Salt substitutes often contain potassium chloride, which can exacerbate this risk. Reviewing ingredients prevents excessive potassium intake, which could lead to dangerous cardiac arrhythmias, demonstrating proper understanding of dietary precautions.

Choice B reason: Missing a dose of lisinopril if feeling unwell is dangerous, as it may worsen hypertension or heart failure. Consistent dosing is critical to maintain therapeutic effects, and this statement indicates a misunderstanding requiring further teaching on medication adherence.

Choice C reason: Dizziness upon standing (orthostatic hypotension) is a side effect of lisinopril due to vasodilation and reduced blood pressure. Accepting this as normal without reporting it could delay intervention for excessive hypotension, indicating a need for further education.

Choice D reason: Unlimited intake of high-potassium foods like potatoes, bananas, and oranges can lead to hyperkalemia in clients taking lisinopril, risking cardiac arrhythmias. This statement reflects a lack of understanding of dietary potassium restrictions, necessitating further teaching on safe dietary practices.

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Correct Answer is D

Explanation

Choice A reason: Resting after meals may suggest the client is avoiding purging, a positive step in bulimia recovery. However, it does not address the underlying emotional triggers driving binge-purge cycles. Without developing healthier coping mechanisms, resting alone is insufficient to indicate significant progress in managing the disorder.

Choice B reason: Verbalizing knowledge of past eating patterns shows insight into bulimia nervosa but does not necessarily indicate behavioral change. Understanding patterns is a preliminary step, but without implementing healthier coping strategies, it does not demonstrate active progress in altering the binge-purge cycle or emotional regulation.

Choice C reason: Identifying calorie content reflects awareness of food intake, which may be part of nutritional education in bulimia treatment. However, this knowledge alone does not address the emotional or behavioral components of the disorder, such as binge-purge triggers, making it less indicative of positive progress.

Choice D reason: Bulimia nervosa is often driven by emotional distress, with binge-purge behaviors as maladaptive coping mechanisms. Exhibiting healthy ways to cope with emotions, such as through therapy or stress management techniques, directly addresses the root cause, reducing reliance on disordered eating and indicating significant progress in recovery.

A. Blue cheese, red wine, raisins B. Milk, peanuts, tomatoes C. Shellfish, grapefruit, egg yolks D. Juice, pears, black beans

Correct Answer is A

Explanation

Choice A reason: Phenelzine, an MAOI, inhibits monoamine oxidase, leading to tyramine accumulation. Tyramine-rich foods like blue cheese, red wine, and raisins can cause hypertensive crises by triggering norepinephrine release, leading to dangerous blood pressure spikes, making this the correct dietary restriction advice.

Choice B reason: Milk, peanuts, and tomatoes are not high in tyramine and do not interact significantly with phenelzine. These foods are generally safe for clients on MAOIs, as they do not trigger the hypertensive crises associated with tyramine-rich foods, making this incorrect.

Choice C reason: Shellfish, grapefruit, and egg yolks are not tyramine-rich and do not pose a significant risk with phenelzine. Grapefruit affects cytochrome P450 enzymes, not MAOIs, and shellfish and egg yolks are safe, making this an incorrect dietary restriction.

Choice D reason: Juice, pears, and black beans are low in tyramine and safe for clients taking phenelzine. They do not cause the hypertensive crises associated with MAOI-related ty/annine interactions, making this an incorrect choice for foods to avoid.

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The nurse is providing discharge instructions to a client who is prescribed lisinopril, an ACE inhibitor. Which statement by the client demonstrates proper understanding of the discharge instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is evaluating the progress of a client with bulimia. Which behavior would indicate that the client is making positive progress?

Correct Answer is D

Explanation

A client with depression is prescribed phenelzine (Nardil). The client says to the nurse, “I will need to watch my diet with this medication. What food options should I avoid?” Which of the following is the correct response by the nurse?

Correct Answer is A

Explanation

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