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 healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?

• A. Atrophic vaginitis
• B. Dysfunctional uterine bleeding
• C. Osteoporosis
• D. Thrombophlebitis

Correct answer: D

Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.

3. When educating a client with a new prescription for Amlodipine, which instruction should the nurse provide?

• A. Increase your intake of dairy products.
• B. Avoid driving until you see how the medication affects you.
• C. Stop taking the medication if you develop a dry cough.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to advise the client to avoid driving until they understand the medication's effects. Amlodipine can cause dizziness, making it unsafe to drive until the client knows how the medication affects them. This instruction promotes client safety and prevents potential accidents due to medication side effects.

4. Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?

• A. Heparin
• B. Alprazolam
• C. Digoxin
• D. Levothyroxine

Correct answer: C

Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.

5. What is the antidote for Warfarin?

• A. Vitamin D
• B. Vitamin C
• C. Vitamin K
• D. Vitamin B6

Correct answer: C

Rationale: Vitamin K is the antidote for Warfarin toxicity as it helps reverse the anticoagulant effects of Warfarin. Warfarin works by inhibiting vitamin K-dependent clotting factors, and administering vitamin K can replenish these factors, thereby counteracting the anticoagulant effects of Warfarin. Vitamin D, Vitamin C, and Vitamin B6 do not have the specific mechanism to counteract the anticoagulant effects of Warfarin, making them incorrect choices.

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