Nursing Elites

1. A client with asthma is prescribed fluticasone. The nurse should instruct the client to use this medication at which time?

• A. During an asthma attack
• B. Twice a day
• C. Once a day
• D. At night before bed

Correct answer: C

Rationale: Fluticasone is a maintenance medication for asthma aimed at controlling symptoms. It should be taken once a day on a regular basis to provide ongoing relief and prevent asthma symptoms, rather than being used to treat acute asthma attacks. Therefore, the correct answer is to use it once a day. Choices A, B, and D are incorrect because using fluticasone during an asthma attack, twice a day, or only at night before bed does not align with the medication's purpose of being a daily maintenance therapy.

2. A client with hypertension is prescribed atenolol. The nurse should monitor the client for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hypotension
• D. Hyperglycemia

Correct answer: A

Rationale: When a client is prescribed atenolol, a beta-blocker medication used to treat hypertension, the nurse should monitor for bradycardia as a potential side effect. Atenolol works by slowing the heart rate, and one common adverse effect is bradycardia, which is a slower than normal heart rate. Monitoring the client's heart rate is essential to detect and manage this potential side effect promptly. Choices B, C, and D are incorrect because atenolol typically does not cause tachycardia, hypotension, or hyperglycemia as primary side effects. Instead, bradycardia is a common concern due to the drug's mechanism of action in reducing heart rate.

3. A client with a history of deep vein thrombosis is prescribed dabigatran. The nurse should monitor for which potential adverse effect?

• A. Bleeding
• B. Weight gain
• C. Headache
• D. Nausea

Correct answer: A

Rationale: Dabigatran is an anticoagulant that increases the risk of bleeding. Therefore, the nurse should closely monitor the client for signs of bleeding, such as easy bruising, blood in the urine or stool, prolonged bleeding from cuts, or nosebleeds, to ensure early detection and intervention.

4. A client with diabetes mellitus type 1 is prescribed insulin lispro. When should the nurse instruct the client to administer this medication?

• A. 5-10 minutes before meals
• B. 15 minutes after meals
• C. 30 minutes before meals
• D. 1 hour after meals

Correct answer: A

Rationale: Corrected Rationale: Insulin lispro is a rapid-acting insulin that should be administered 5-10 minutes before meals. This timing helps synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing postprandial hyperglycemia. Choice B, administering 15 minutes after meals, is incorrect because rapid-acting insulins like lispro are meant to act quickly to cover the rise in blood glucose levels after meals. Choices C and D are also incorrect as they do not align with the rapid onset of action required to manage postprandial hyperglycemia in patients with diabetes mellitus type 1.

5. A client admitted with shortness of breath and palpitations currently takes an antiarrhythmic medication, dronedarone. Which action should the nurse take to prevent arrhythmias?

• A. Measure orthostatic blood pressure
• B. Obtain a 12-lead ECG reading daily
• C. Assess the client's apical pulse daily
• D. Provide continuous ECG monitoring

Correct answer: D

Rationale: The correct action to prevent arrhythmias in a client taking an antiarrhythmic medication like dronedarone is to provide continuous ECG monitoring. This is essential because antiarrhythmic drugs can sometimes cause pro-arrhythmic effects, which may lead to dangerous heart rhythm disturbances. Continuous ECG monitoring allows for real-time detection of any abnormal rhythms, enabling prompt intervention. Measuring orthostatic blood pressure, obtaining a 12-lead ECG reading daily, and assessing the client's apical pulse daily are important assessments in general patient care but may not specifically prevent arrhythmias in this scenario.

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