Nursing Elites

1. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

2. A client has a new prescription for colchicine to treat gout. Which of the following instructions should be included?

• A. Take this medication with food if nausea develops.
• B. Monitor for muscle pain.
• C. Expect to have increased bruising.
• D. Increase your intake of grapefruit juice.

Correct answer: B

Rationale: Monitoring for muscle pain is crucial when taking colchicine because it can lead to rhabdomyolysis, a serious condition characterized by muscle breakdown. This adverse effect needs prompt identification to prevent complications. Choices A, C, and D are incorrect because taking colchicine with food, experiencing increased bruising, or increasing grapefruit juice intake are not relevant instructions for a client prescribed colchicine for gout.

3. Which of the following drugs has a therapeutic effect that prevents thromboembolic events?

• A. Warfarin
• B. Amlodipine
• C. Nitroglycerin
• D. Clopidogrel

Correct answer: A

Rationale: The correct answer is Warfarin. Warfarin is an anticoagulant medication that helps prevent thromboembolic events by inhibiting the formation of blood clots. It is commonly used to reduce the risk of strokes or heart attacks in patients at risk for thrombosis.

4. A client is starting therapy with doxorubicin. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The correct answer is 'C: Sore throat.' Doxorubicin is known to have immunosuppressive effects, which can predispose the client to infections. A sore throat can be an early sign of infection, and prompt reporting to the healthcare provider is crucial to initiate appropriate interventions and prevent complications. Choices A, B, and D are incorrect because hair loss, fatigue, and red urine are common side effects of doxorubicin and are typically expected during therapy. While these side effects should be monitored, they do not require immediate reporting unless they become severe or concerning.

5. The healthcare professional is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the healthcare professional to question administering this drug?

• A. Respirations 12 breaths per minute
• B. Pulse 52 beats per minute
• C. Blood pressure 134/72
• D. Oxygen saturation 95%

Correct answer: B

Rationale: Atenolol is a beta-blocker medication that can lower heart rate. A pulse of 52 beats per minute is relatively low and administering atenolol could further decrease the heart rate, potentially leading to bradycardia. Monitoring the pulse rate and holding the medication if the pulse is below the prescribed parameters is crucial to prevent adverse effects such as bradycardia and hypotension.

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