Nursing Elites

1. A client has a new prescription for Omeprazole. Which of the following statements should the nurse include in teaching the client?

• A. Take the medication before meals.
• B. You may experience a rapid heart rate.
• C. Increase your intake of high-calcium foods.
• D. Expect your urine to turn orange.

Correct answer: A

Rationale: The correct statement for the nurse to include when teaching a client prescribed Omeprazole is to take the medication before meals. Omeprazole, a proton pump inhibitor, is most effective when taken before meals as it works by reducing the amount of acid produced in the stomach. Choice B is incorrect because a rapid heart rate is not a common side effect of Omeprazole. Choice C is incorrect as there is no specific requirement to increase intake of high-calcium foods with Omeprazole. Choice D is also incorrect as Omeprazole does not typically cause urine discoloration.

2. A client is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

• A. Decreased blood pressure
• B. Increase in HDL cholesterol
• C. Prevention of bipolar manic episodes
• D. Improved sexual function

Correct answer: A

Rationale: The therapeutic effect of lisinopril, an ACE inhibitor, is indicated by a decrease in blood pressure. Lisinopril works by relaxing blood vessels, leading to a reduction in blood pressure. Monitoring and achieving a decrease in blood pressure is a key outcome when managing hypertension with lisinopril. Choices B, C, and D are incorrect because lisinopril is not intended to increase HDL cholesterol, prevent bipolar manic episodes, or improve sexual function. Therefore, the correct outcome indicating the therapeutic effect of lisinopril is a decrease in blood pressure.

3. A healthcare professional is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare professional plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 min.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hr of manifestation onset.

Correct answer: B

Rationale: The correct intervention when administering IV Alteplase is to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This helps prevent bleeding complications associated with thrombolytic therapy. Administering IM Enoxaparin is not indicated with Alteplase, as it is an anticoagulant rather than a thrombolytic agent. Aminocaproic acid is not typically administered prior to alteplase infusion in the context of a massive Pulmonary Embolism. While timely administration of Alteplase is important, the specific timeframe within which it should be administered may vary based on the clinical situation, so a strict 8-hour window is not universally applicable.

4. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Monitor the client's blood pressure after administering Propranolol.
• C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
• D. Monitor the client's potassium levels for signs of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.

5. A healthcare professional is caring for a group of clients receiving antimicrobial therapy. Which of the following clients should the professional plan to monitor for manifestations of antibiotic toxicity?

• A. An adolescent client with a sinus infection
• B. An older adult client with prostatitis
• C. A client who is postpartum with mastitis
• D. A middle-aged client with a urinary tract infection

Correct answer: B

Rationale: An older adult client with prostatitis who is receiving antibiotics should be monitored for toxicity due to age-related reductions in medication metabolism and excretion. Older adults are more susceptible to antibiotic toxicity, making them a high-risk group for adverse effects.

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