Nursing Elites

1. A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Limit your sodium intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client taking Metoprolol, a medication used to treat hypertension, is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down to standing up, leading to dizziness and falls. By advising the client to change positions slowly, the nurse helps prevent these adverse effects and promotes safety.

2. A client is receiving moderate sedation with Diazepam IV and is oversedated. Which of the following medications should the nurse anticipate administering to this client?

• A. Ketamine
• B. Naltrexone
• C. Flumazenil
• D. Fluvoxamine

Correct answer: C

Rationale: Flumazenil is a specific benzodiazepine antagonist that competitively reverses the sedative effects of benzodiazepines like Diazepam. In cases of oversedation or respiratory depression caused by benzodiazepines, administering Flumazenil can help reverse the effects and restore the client's consciousness and respiratory drive. Ketamine (Choice A) is a dissociative anesthetic and not used to reverse benzodiazepine sedation. Naltrexone (Choice B) is an opioid receptor antagonist and not indicated for benzodiazepine oversedation. Fluvoxamine (Choice D) is an antidepressant and not used to counteract benzodiazepine sedation.

3. A client is being discharged with a new prescription for Atenolol. Which of the following instructions should the nurse include?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid consuming foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your heart rate regularly.' Atenolol is a beta-blocker that can cause bradycardia (slow heart rate). Monitoring the heart rate regularly is crucial to promptly detect any significant decreases. This allows for timely intervention and adjustment of the medication regimen if needed, helping to prevent adverse effects associated with bradycardia. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning does not address the need for heart rate monitoring. Avoiding foods high in potassium is more relevant for medications like ACE inhibitors or potassium-sparing diuretics. Increasing fluid intake is not directly related to the use of Atenolol.

4. A client is prescribed Metformin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin A1c
• D. Serum creatinine

Correct answer: D

Rationale: The correct answer is D: Serum creatinine. Metformin can potentially cause lactic acidosis, particularly in patients with impaired renal function. Monitoring serum creatinine levels is crucial to assess kidney function and detect any adverse effects of Metformin on renal health. Choices A, B, and C are incorrect as blood glucose, creatine kinase, and hemoglobin A1c levels are not directly monitored to assess for potential adverse effects of Metformin. Blood glucose monitoring is typically done to assess the efficacy of antidiabetic medications like Metformin, while creatine kinase levels are indicative of muscle damage and hemoglobin A1c reflects long-term blood sugar control.

5. When teaching a client with a new prescription for warfarin, which statement should the nurse include?

• A. Avoid using a soft toothbrush.
• B. Avoid foods high in vitamin K.
• C. Report any signs of bleeding to your provider.
• D. Use an electric shaver for shaving.

Correct answer: C

Rationale: The correct statement the nurse should include when teaching a client with a new prescription for warfarin is to report any signs of bleeding to their provider. Bleeding can indicate excessive anticoagulation, a potential side effect of warfarin therapy that needs prompt medical attention. Choices A, B, and D are incorrect because while oral hygiene measures, dietary considerations, and skin care are important, they are not the priority when teaching a client about warfarin therapy. Monitoring for and reporting signs of bleeding is crucial due to the anticoagulant effects of warfarin.

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