Nursing Elites

1. Atenolol hydrochloride (Tenormin) is prescribed for a hospitalized client. The nurse should perform which of the following as a priority action before administering the medication?

• A. Listen to the client's lung sounds.
• B. Check the client's blood pressure.
• C. Check the recent electrolyte levels.
• D. Assess the client for muscle weakness.

Correct answer: B

Rationale: Atenolol hydrochloride is a beta-blocker used to treat hypertension. Checking the client's blood pressure is crucial before administration.

2. The healthcare provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatment?

• A. The medication is an antibacterial.
• B. The medication will help heal the burn.
• C. The medication will permanently stain my skin.
• D. The medication should be applied directly to the wound.

Correct answer: C

Rationale: The correct answer is C. Silver sulfadiazine is an antibacterial used to treat burns, helping in the healing process. It does not permanently stain the skin. Therefore, the statement indicating a lack of understanding is that the medication will permanently stain the skin.

3. A client is being educated about the use of levodopa-carbidopa (Sinemet) for Parkinson's disease. Which statement by the client indicates a need for further teaching?

• A. I should avoid taking the medication with a high-protein meal.
• B. I may experience dizziness when getting up quickly.
• C. I might notice a darkening of my urine.
• D. I should report any uncontrolled movements to my healthcare provider.

Correct answer: A

Rationale: The correct answer is A. Levodopa-carbidopa (Sinemet) should not be taken with a high-protein meal as protein can interfere with the absorption of the medication. It is recommended to take it on an empty stomach or with a light meal. Choices B, C, and D are accurate statements regarding potential side effects and actions to take while on levodopa-carbidopa therapy, indicating a good understanding by the client.

4. A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, 'My chest still hurts.' Select the appropriate actions that the nurse should take.

• A. Call a code blue.
• B. Contact the registered nurse.
• C. Contact the client's family.
• D. Assess the client's pain level.

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to contact the registered nurse. When a client with coronary artery disease experiences chest pain and does not achieve relief after the initial administration of nitroglycerin, it is crucial to inform the registered nurse promptly. Following the usual guideline for nitroglycerin administration, the nurse may administer a second tablet after assessing the client's pain level. The nurse should continue to assess the client's pain and monitor vital signs before each dose administration. Calling a code blue is not warranted at this point, as the client's condition does not indicate an immediate life-threatening emergency. Contacting the client's family is not necessary unless requested by the client.

5. The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?

• A. Resolved diarrhea
• B. Relief of epigastric pain
• C. Decreased platelet count
• D. Decreased white blood cell count

Correct answer: B

Rationale: Misoprostol is a gastric protectant administered to clients using NSAIDs to prevent gastric mucosal injury. Relief of epigastric pain signifies the medication's therapeutic effect as it indicates a reduction in gastrointestinal symptoms associated with NSAID use.

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