Nursing Elites

1. When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?

• A. “Your chest pain should go away with one tablet.”
• B. “If your chest pain doesn’t go away after three tablets, call 911; you might be having a heart attack.”
• C. “If your chest pain doesn’t go away with one tablet, you can repeat the dose as many times as you need to.”
• D. “Be sure to call 911 before you take any tablets.”

Correct answer: B

Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.

2. When teaching parents about a child newly prescribed Desipramine, the nurse should instruct them that which of the following adverse effects is the priority to report to the provider?

• A. Constipation
• B. Suicidal thoughts
• C. Photophobia
• D. Dry mouth

Correct answer: B

Rationale: The priority adverse effect to report when a child is prescribed Desipramine is suicidal thoughts. Desipramine can increase the risk of suicidal thoughts and behaviors. It is crucial for parents to monitor the child for any signs of worsening depression or thoughts of self-harm and report them promptly to the healthcare provider to prevent any harm to the child. Options A, C, and D are potential side effects of Desipramine but are not as urgent or life-threatening as suicidal thoughts, which require immediate intervention to ensure the safety of the child.

3. A client has a new prescription for Nitrofurantoin. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid dairy products while taking this medication.
• C. Take this medication at bedtime.
• D. Increase your intake of vitamins.

Correct answer: A

Rationale: The correct instruction for a client prescribed Nitrofurantoin is to take the medication with food. Taking Nitrofurantoin with food helps enhance absorption and reduces the risk of gastrointestinal side effects. It is important for the nurse to emphasize this instruction to ensure the client benefits optimally from the medication. Choices B, C, and D are incorrect. Avoiding dairy products is not specifically required with Nitrofurantoin. Taking the medication at bedtime is not a standard instruction. Increasing vitamin intake is not necessary in relation to Nitrofurantoin therapy.

4. 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.

5. A nurse is caring for a client with hypertension who asks about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients with a history of which of the following conditions?

• A. Asthma
• B. Glaucoma
• C. Depression
• D. Migraines

Correct answer: A

Rationale: Corrected Rationale: Propranolol is contraindicated in clients with a history of asthma because it can cause bronchospasms due to its non-selective beta-blocking properties. By blocking beta-2 receptors in the lungs, propranolol can lead to bronchoconstriction, potentially triggering asthma symptoms and exacerbating respiratory issues. Asthma patients should avoid medications like propranolol that can worsen their condition. Choices B, C, and D are incorrect as propranolol is not contraindicated in clients with glaucoma, depression, or migraines. In fact, propranolol is sometimes used in the treatment of migraines and certain types of glaucoma.

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