Nursing Elites

1. A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Increase your fluid intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client starting Metoprolol is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, leading to dizziness and falls if the client changes positions quickly. By advising the client to make position changes slowly, the nurse helps prevent these adverse effects and promotes safety.

2. A client is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?

• A. Light yellow urine
• B. Report of tinnitus
• C. Productive cough
• D. Blue-gray skin discoloration

Correct answer: D

Rationale: Blue-gray skin discoloration is a common sign of Amiodarone toxicity, known as blue-gray discoloration, which can affect areas like the face, neck, or hands. It is important to monitor for this side effect, as it can be a visible indicator of potential toxicity. Choices A, B, and C are incorrect. Light yellow urine is not typically associated with Amiodarone toxicity. Tinnitus is not a common manifestation of Amiodarone toxicity. A productive cough is not a recognized symptom of Amiodarone toxicity.

3. A nurse is teaching a client who has a new prescription for Prednisone. Which of the following instructions should the nurse include?

• A. Increase your intake of vitamin
• B. Take this medication on an empty stomach.
• C. Avoid drinking grapefruit juice.
• D. Take this medication every other day.

Correct answer: A

Rationale: Prednisone can lead to bone loss, so clients should increase their intake of vitamin D and calcium to help maintain bone health.

4. 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.

5. While providing teaching to a client with a new prescription for Enalapril, the nurse should instruct the client to report which of the following manifestations as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: The correct answer is 'B: Dry cough.' Enalapril is an ACE inhibitor known to cause a persistent dry cough as a common adverse effect. This cough should be reported to the healthcare provider for further evaluation, as it may indicate a potential issue with the medication that needs attention to ensure the client's well-being. Tremors (Choice A), drowsiness (Choice C), and hyperactivity (Choice D) are not typically associated with Enalapril use. Therefore, they are incorrect choices for this question.

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