Nursing Elites

1. A healthcare provider is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The provider should recognize which of the following conditions is a contraindication for taking propranolol?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Asthma. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms. Choices B, C, and D are incorrect. Glaucoma, hypertension, and tachycardia are not contraindications for taking propranolol. In fact, propranolol is commonly used to treat hypertension and tachycardia.

2. When does regular insulin typically peak?

• A. 30 minutes to 2 ½ hours
• B. 1 to 3 hours
• C. 6 to 14 hours
• D. 1 to 5 hours

Correct answer: D

Rationale: Regular insulin usually peaks around 1 to 5 hours after administration. This peak time frame is important to consider when managing blood glucose levels and timing meals to coincide with insulin activity. Choice A, '30 minutes to 2 ½ hours,' is incorrect because regular insulin typically peaks later. Choice B, '1 to 3 hours,' is not the most accurate as the peak for regular insulin can extend beyond 3 hours. Choice C, '6 to 14 hours,' is incorrect as this timeframe is more indicative of long-acting insulins, not regular insulin.

3. A client has a new prescription for Furosemide. Which of the following dietary instructions should the nurse provide?

• A. Increase your intake of bananas and oranges.
• B. Limit your intake of calcium-rich foods.
• C. Avoid drinking milk.
• D. Increase your intake of green, leafy vegetables.

Correct answer: A

Rationale: The correct answer is A: 'Increase your intake of bananas and oranges.' Furosemide, a loop diuretic, can cause potassium loss leading to hypokalemia. To prevent this, clients should increase their intake of potassium-rich foods, such as bananas and oranges, to replenish potassium levels. Choices B, C, and D are incorrect because limiting calcium-rich foods or avoiding milk is not necessary with Furosemide, and increasing intake of green, leafy vegetables does not specifically address the potential potassium loss associated with this medication.

4. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

5. A client who is receiving combination chemotherapy is exhibiting a temperature of 38.1°C (100.6°F). Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients undergoing chemotherapy due to the heightened risk of sepsis in immunocompromised individuals. Immediate assessment and intervention are crucial to prevent severe complications. Dry oral mucous membranes, nausea and vomiting, and anorexia are common side effects of chemotherapy but are not specific indicators of an oncologic emergency like a fever in this setting.

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