Nursing Elites

1. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Monitor the client's blood pressure after administering Propranolol.
• C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
• D. Monitor the client's potassium levels for signs of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.

2. A healthcare professional working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the healthcare professional's priority?

• A. Administer flumazenil.
• B. Identify the client's level of orientation.
• C. Infuse IV fluids.
• D. Prepare the client for gastric lavage.

Correct answer: B

Rationale: When managing a client with Benzodiazepine toxicity, the priority action for the healthcare professional is to assess the client. Identifying the client's level of orientation allows the healthcare professional to understand the client's cognitive status, which is crucial for further interventions and decision-making in the care plan. Administering flumazenil (Choice A) may precipitate withdrawal symptoms and should be done cautiously. Infusing IV fluids (Choice C) can be important but is not the priority over assessing the client. Gastric lavage (Choice D) is not typically recommended due to the risk of complications and its limited effectiveness in cases of Benzodiazepine overdose.

3. A nurse is teaching a client who has a new prescription for Atenolol. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: Atenolol is a beta-blocker that can cause bradycardia as an adverse effect. The client should monitor their pulse regularly and report any significant decreases.

4. A client with peptic ulcer disease is being taught about managing the condition. Which of the following statements indicates an understanding of the teaching?

• A. I should eat small, frequent meals that are low in fiber.
• B. I will limit my intake of caffeine-containing beverages.
• C. I should take NSAIDs to relieve my pain.
• D. I will drink milk before bedtime to decrease acid production.

Correct answer: B

Rationale: The correct answer is B: 'I will limit my intake of caffeine-containing beverages.' Limiting intake of caffeine-containing beverages is important for managing peptic ulcer disease as caffeine can stimulate gastric acid secretion, which may worsen the condition. It is advisable to choose decaffeinated beverages and avoid caffeinated drinks to help reduce the risk of aggravating the ulcer. Choices A, C, and D are incorrect. Choice A suggests eating small, frequent meals low in fiber, which is not ideal for managing peptic ulcer disease. Choice C of taking NSAIDs is contraindicated as NSAIDs can worsen peptic ulcers. Choice D of drinking milk before bedtime to decrease acid production is a common misconception; while milk may temporarily neutralize stomach acid, it can stimulate more acid production later, making the condition worse.

5. A female client with tobacco use disorder is being educated by a nurse about Nicotine replacement therapy. Which of the following statements by the client shows understanding of the teaching?

• A. I should avoid eating right before I chew a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking if I become pregnant.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. The client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum. Choice B is incorrect because there is no specified timeline for stopping nicotine gum use. Choice C is incorrect because nicotine gum is not recommended during pregnancy. Choice D is incorrect as the client should chew the nicotine gum slowly for about 30 minutes, not quickly for 15 minutes.

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