Nursing Elites

1. A client has a new prescription for Lovastatin. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Take this medication in the morning.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct instruction for taking Lovastatin is to take it at bedtime. Cholesterol production in the liver is highest at night, so taking Lovastatin at bedtime aligns with the body's natural rhythm and maximizes its effectiveness.

2. In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A). Sodium bicarbonate (Choice B) is not indicated for hypotension related to Verapamil use. Potassium chloride (Choice C) and Magnesium sulfate (Choice D) are not the appropriate medications to address the hypotension in this situation.

3. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Administer Propranolol to decrease the client's blood pressure.
• C. Assist the client with sitting up or standing after taking this medication.
• D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.

4. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old who has no health problems
• B. 17-year-old who has a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.

5. When educating a client starting a new prescription for metoprolol, which instruction should the nurse include?

• A. Check your pulse before taking the medication.
• B. Take the medication with food to increase absorption.
• C. Avoid sudden changes in position.
• D. Monitor your blood pressure regularly.

Correct answer: C

Rationale: The correct instruction for a client starting metoprolol is to avoid sudden changes in position. Metoprolol can cause dizziness due to its blood pressure-lowering effects, increasing the risk of falls and injury. Instructing the client to change positions slowly helps prevent orthostatic hypotension and related adverse events. Checking the pulse before taking the medication (Choice A) is not typically necessary for metoprolol. Taking the medication with food (Choice B) is not required for absorption and can be taken with or without food. Monitoring blood pressure regularly (Choice D) is essential for clients taking metoprolol, but avoiding sudden changes in position is more critical to prevent dizziness and falls.

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