Nursing Elites

1. A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.

2. What is the therapeutic use of Phenytoin?

• A. Replacement in hypothyroidism to restore normal hormonal balance
• B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
• C. Diminished seizure activity, termination of ventricular arrhythmias
• D. Prevention of thrombus formation, prevention of extension of existing thrombi

Correct answer: C

Rationale: Phenytoin is primarily used to diminish seizure activity and is effective in terminating ventricular arrhythmias. It works by stabilizing neuronal membranes, reducing repetitive neuronal firing, and limiting the spread of seizure activity in the brain. While phenytoin does not have a direct role in preventing thrombus formation or extending existing thrombi, it is crucial in managing seizures and certain arrhythmias.

3. A client has a new prescription for atenolol. Which of the following findings should the nurse instruct the client to monitor for as an adverse effect of this medication?

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

Correct answer: C

Rationale: The correct answer is 'C: Bradycardia.' Atenolol, a beta-blocker, commonly causes bradycardia as an adverse effect. It works by slowing down the heart rate, which can lead to a decreased heart rate known as bradycardia. Monitoring for signs of bradycardia is essential to prevent any potential complications while on atenolol. Choices A, B, and D are incorrect because atenolol is not known to cause tachycardia, hypoglycemia, or hypertension as common adverse effects.

4. A nurse is providing instructions to a client who has a prescription for Amoxicillin and Clarithromycin to treat a Peptic Ulcer. Which of the following information should the nurse include in the teaching?

• A. Take these medications with foo '
• B. These medications can turn your stool black.'
• C. These medications can cause photosensitivity.'
• D. The purpose of these medications is to decrease the pH of gastric juices in the stomach.'

Correct answer: A

Rationale: The nurse should instruct the client to take these medications with food to reduce GI disturbances.

5. A healthcare provider is reviewing a client's health record and notes that the client is experiencing episodes of hypokalemia. Which of the following medications should the healthcare provider identify as a cause of the client's hypokalemia?

• A. Captopril
• B. Lisinopril
• C. Furosemide
• D. Spironolactone

Correct answer: C

Rationale: Furosemide is a loop diuretic that acts on the kidneys to increase urine production. This increased urine output can lead to the excessive excretion of potassium, resulting in hypokalemia. Monitoring potassium levels and considering supplementation may be necessary when a patient is on furosemide to prevent or manage hypokalemia.

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