Nursing Elites

1. A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?

• A. Administer the medication as prescribed
• B. Administer half of the normal dose
• C. Consider the extended-release form of the medication
• D. Withhold administration of the medication and notify the healthcare provider

Correct answer: D

Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.

2. A client has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take this medication in the morning.
• B. Consume foods rich in potassium.
• C. Take this medication with a meal.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: Hydrochlorothiazide is a diuretic that can lead to dehydration due to increased urination. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. It is essential to educate the client to monitor these signs and seek medical attention if they occur. Choice A is incorrect because Hydrochlorothiazide is usually taken in the morning to prevent disruption of sleep due to increased urination during the night. Choice B is incorrect because while Hydrochlorothiazide can lead to potassium loss, consuming foods rich in potassium is not a specific instruction related to this medication. Choice C is incorrect because taking Hydrochlorothiazide with a meal is not a specific requirement for its administration.

3. A client with HIV is starting therapy with zidovudine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Fatigue
• B. Blurred vision
• C. Ringing in the ears
• D. Constipation

Correct answer: A

Rationale: Fatigue is a common adverse effect of zidovudine due to its impact on bone marrow, leading to anemia. Zidovudine is known to cause bone marrow suppression, resulting in decreased production of red blood cells and subsequent fatigue.

4. A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?

• A. Reflex tachycardia
• B. Dizziness
• C. Hyponatremia
• D. Hypotension

Correct answer: C

Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.

5. A client has a new prescription for Pancrelipase. Which of the following instructions should the nurse include?

• A. Take the medication with meals and snacks.
• B. Expect your urine to turn orange.
• C. Increase your intake of high-calcium foods.
• D. Avoid consuming dairy products.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with meals and snacks.' Pancrelipase should be taken with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This timing ensures that the medication functions optimally by assisting in the digestion process when food is present in the gastrointestinal system. Choice B is incorrect because urine discoloration is not a common side effect of Pancrelipase. Choice C is incorrect as there is no specific need to increase high-calcium foods with Pancrelipase. Choice D is also incorrect as avoiding dairy products is not necessary when taking Pancrelipase.

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