Nursing Elites

1. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients who develop tachycardia, such as in the case of reflex tachycardia induced by Isosorbide Mononitrate, making it the appropriate choice in this scenario. Furosemide (Choice A) is a loop diuretic used for conditions like heart failure and edema, not for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor primarily used for hypertension and heart failure, not for reflex tachycardia. Ranolazine (Choice C) is used for chronic angina but does not specifically address reflex tachycardia.

2. A client in a critical care unit is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?

• A. Prone
• B. On the nonoperative side
• C. Sims'
• D. Semi-Fowler's

Correct answer: D

Rationale: After a pneumonectomy, positioning the client in a semi-Fowler's position is crucial for optimal ventilation. This position helps improve lung expansion on the remaining side, facilitating better oxygenation and preventing complications like atelectasis. Placing the client prone, on the nonoperative side, or in Sims' position would not provide the same respiratory benefits post-pneumonectomy.

3. A client has a new prescription for Prednisone. Which of the following instructions should be included in the discharge teaching?

• A. Increase your intake of potassium-rich foods.
• B. Avoid consuming grapefruit juice.
• C. Take this medication with food.
• D. Decrease your intake of sodium-rich foods.

Correct answer: A

Rationale: The correct answer is A: 'Increase your intake of potassium-rich foods.' Prednisone can lead to potassium depletion, making it important for clients to increase their intake of potassium-rich foods like bananas, oranges, and spinach to prevent potential complications. Choice B is incorrect because grapefruit juice can interact with certain medications, but it is not a specific concern with Prednisone. Choice C is incorrect as Prednisone can be taken with or without food. Choice D is also incorrect because there is no direct relationship between Prednisone and sodium-rich foods.

4. A client has a prescription for Phenytoin. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Increase your intake of calcium-rich foods.
• C. Brush and floss your teeth regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a condition that leads to overgrowth of gum tissue. Good oral hygiene practices such as regular brushing and flossing can help prevent or minimize this side effect. In contrast, choices A, B, and D are not directly related to managing the side effects of Phenytoin. Taking the medication at bedtime (choice A) is not a specific instruction related to oral hygiene. Increasing calcium-rich foods intake (choice B) may be beneficial for bone health but is not directly related to preventing gingival hyperplasia. Avoiding foods high in potassium (choice D) is not a necessary instruction for a client taking Phenytoin.

5. Which of the following is not a side effect of the cholinoreceptor blocker (Atropine)?

• A. Increased pulse
• B. Diarrhea
• C. Constipation
• D. Mydriasis

Correct answer: B

Rationale: Atropine, an anticholinergic drug, commonly causes side effects like increased pulse, mydriasis (dilated pupils), and constipation due to its inhibitory effect on the parasympathetic nervous system. Diarrhea is not typically a side effect of Atropine, making it the correct answer.

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