Nursing Elites

1. The healthcare provider is preparing to administer a calcium channel blocker to a client with hypertension. What parameter should be checked before administering the medication?

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

Correct answer: C

Rationale: Before administering a calcium channel blocker to a client with hypertension, the healthcare provider should check the client's blood pressure. Calcium channel blockers are used to lower blood pressure, making it essential to assess the current blood pressure to ensure it is within the appropriate range for administration. Checking the apical pulse (choice A) is not the priority before administering a calcium channel blocker, as the focus should be on blood pressure. Serum calcium level (choice B) is not directly related to the administration of calcium channel blockers for hypertension. Respiratory rate (choice D) is not the primary parameter to check before administering a calcium channel blocker in this scenario.

2. The nurse is preparing to administer an intravenous dose of potassium chloride to a client with hypokalemia. The nurse should monitor for which potential complication?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: A

Rationale: When administering potassium chloride to a client with hypokalemia, the nurse should monitor for hyperkalemia. Potassium chloride supplementation aims to increase potassium levels in individuals with hypokalemia. However, excessive administration can lead to hyperkalemia, which can be a serious and potentially life-threatening complication. Monitoring potassium levels is crucial to prevent this adverse outcome. Hypokalemia (Choice B) is the condition being treated, so it is not a complication of treatment. Hypernatremia (Choice C) refers to high sodium levels and is not directly related to the administration of potassium chloride. Hypercalcemia (Choice D) is an elevated calcium level and is not a common complication associated with potassium chloride administration in hypokalemia.

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

• A. Store the medication in a cool, dry place.
• B. Take the medication as directed by the healthcare provider.
• C. Take the medication 30 minutes before meals.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: Instructing the client to take nitroglycerin at the first sign of chest pain is crucial for immediate relief of angina symptoms. Nitroglycerin is a fast-acting medication that helps dilate blood vessels, improving blood flow to the heart muscle. Therefore, prompt administration at the onset of chest pain is essential to alleviate anginal episodes effectively. Choices A, B, and C are incorrect because storing the medication properly, taking it as directed, or before meals are not specific instructions for managing acute anginal episodes, which require immediate action for symptom relief.

4. A healthcare professional is preparing to administer a unit of packed red blood cells to a client. Which of the following actions should the healthcare professional take?

• A. Prime the blood tubing with normal saline.
• B. Verify the client’s identity using two identifiers.
• C. Infuse the blood rapidly over 30 minutes.
• D. Obtain the client’s vital signs every 4 hours during the transfusion.

Correct answer: B

Rationale: Verifying the client’s identity using two identifiers is a critical patient safety measure to ensure the correct patient receives the blood transfusion. This process involves checking the patient's identity using at least two unique identifiers, such as name, date of birth, or medical record number, to prevent administration errors. Priming the blood tubing with normal saline is necessary to ensure there are no air bubbles in the tubing, but it is not the immediate action required before administering the blood. Infusing packed red blood cells over 30 minutes is generally too rapid and can lead to adverse reactions; a slower rate is recommended for safe administration. Obtaining vital signs every 4 hours during the transfusion is not frequent enough to monitor the client adequately for potential transfusion reactions or complications; vital signs should be monitored more frequently, especially during the initial phase of the transfusion.

5. The client is receiving enalapril (Vasotec). The nurse should monitor the client for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Tachycardia
• D. Hyperglycemia

Correct answer: B

Rationale: Enalapril is an ACE inhibitor that works by dilating blood vessels and reducing blood pressure. Therefore, monitoring for hypotension is crucial as it can be a potential adverse effect of this medication. Hypertension, tachycardia, and hyperglycemia are not typically associated with enalapril use. Hypertension is the condition enalapril is used to treat, so it would not be an adverse effect. Tachycardia is not a common adverse effect of enalapril. Enalapril does not typically cause hyperglycemia, as it primarily affects blood pressure regulation.

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