Nursing Elites

1. A client has a new prescription for atenolol. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Avoid eating foods high in potassium.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to monitor heart rate daily. Atenolol is a beta-blocker that can lead to bradycardia, a condition characterized by a slow heart rate. Monitoring the heart rate daily is essential to detect any abnormal changes promptly, allowing for timely medical intervention if necessary. Choice A is incorrect because atenolol can be taken with or without food. Choice C is irrelevant as atenolol does not interact with potassium-rich foods. Choice D is incorrect as atenolol is usually taken in the morning to help manage blood pressure throughout the day.

2. A client has a new prescription for propranolol. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Increase intake of potassium-rich foods.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is to monitor heart rate daily. Propranolol is a beta-blocker that can lower heart rate and blood pressure, so it is essential to monitor heart rate regularly to detect any signs of bradycardia, a potential side effect of the medication. Choice A is incorrect because propranolol can be taken with or without food. Choice C is incorrect as increasing potassium-rich foods is not specifically required with propranolol. Choice D is also incorrect as there is no need to avoid consuming dairy products with propranolol.

3. Before administering a calcium channel blocker to a client with hypertension, what parameter should the nurse check?

• A. Serum calcium level
• B. Apical pulse
• C. Blood pressure
• D. Respiratory rate

Correct answer: C

Rationale: Before administering a calcium channel blocker to a client with hypertension, the nurse should check the client's blood pressure. Calcium channel blockers are prescribed to lower blood pressure, so it is essential to assess the current blood pressure to ensure safe administration and monitor the medication's effectiveness. Checking the serum calcium level (Choice A) is not necessary before administering a calcium channel blocker, as it does not directly impact the drug's action. Monitoring the apical pulse (Choice B) is important for other types of medications like beta-blockers, not specifically for calcium channel blockers. Assessing the respiratory rate (Choice D) is not directly related to administering calcium channel blockers for hypertension.

4. The client is receiving intravenous heparin for the treatment of a pulmonary embolism. Which medication should the nurse ensure is readily available?

• A. Protamine sulfate
• B. Vitamin K
• C. Calcium gluconate
• D. Magnesium sulfate

Correct answer: A

Rationale: Protamine sulfate is the antidote for heparin, used to reverse its anticoagulant effects. It should be readily available in case of bleeding complications, as it can rapidly neutralize the effects of heparin and prevent excessive bleeding. Vitamin K is used to reverse the effects of warfarin, not heparin (Choice B). Calcium gluconate is used to treat calcium deficiencies, not indicated for heparin therapy (Choice C). Magnesium sulfate is used for conditions like preeclampsia and eclampsia, not for reversing heparin effects (Choice D).

5. A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should reinforce which dietary instruction?

• A. Avoid foods high in vitamin K.
• B. Increase intake of dairy products.
• C. Limit intake of foods high in fiber.
• D. Increase protein intake.

Correct answer: A

Rationale: The correct answer is to avoid foods high in vitamin K. Clients taking warfarin (Coumadin) should maintain a consistent intake of vitamin K to keep the medication's effectiveness stable. Foods high in vitamin K, such as leafy greens, can interfere with the anticoagulant effects of warfarin. Therefore, it is crucial for clients to avoid these foods to ensure the therapeutic effects of warfarin. Choices B, C, and D are incorrect because increasing dairy products, limiting fiber intake, or increasing protein intake do not directly impact the effectiveness of warfarin therapy and are not necessary dietary modifications for clients on this medication.

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