Nursing Elites

1. When administering an Antiulcer Agent, you should be more cautious when administering it to:

• A. A healthy 27-year-old patient
• B. Patient with renal failure
• C. Elderly patients
• D. Choices B & C

Correct answer: D

Rationale: When administering an antiulcer agent, caution is warranted in patients with renal failure due to the potential impact on drug metabolism and excretion. Additionally, elderly patients may be more susceptible to adverse effects from antiulcer agents due to age-related physiological changes. Therefore, it is important to be more cautious when administering antiulcer agents to patients with renal failure and elderly patients. Choice A, a healthy 27-year-old patient, would typically not require as much caution compared to patients with renal failure or elderly patients when administering antiulcer agents. Therefore, choices B & C are the correct options for increased caution.

2. A healthcare provider is assessing a client who is taking levothyroxine. The healthcare provider should recognize that which of the following findings is a manifestation of levothyroxine overdose?

• A. Insomnia
• B. Constipation
• C. Drowsiness
• D. Hypoactive deep-tendon reflexes

Correct answer: A

Rationale: Insomnia is a common symptom of levothyroxine overdose due to excessive stimulation of the central nervous system. Levothyroxine is a thyroid hormone replacement medication, and an overdose can lead to hyperthyroidism symptoms, including insomnia. Constipation and drowsiness are not typically associated with levothyroxine overdose. Hypoactive deep-tendon reflexes are more indicative of hypothyroidism rather than an overdose of levothyroxine.

3. 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.

4. A healthcare professional is educating a client who has a new prescription for warfarin. Which of the following statements should the healthcare professional include?

• A. Avoid foods high in vitamin K.
• B. Report any signs of bleeding to your healthcare provider.
• C. Use a soft toothbrush to prevent gum bleeding.
• D. Use an electric razor to prevent cuts.

Correct answer: B

Rationale: The correct statement that the healthcare professional should include when educating a client prescribed warfarin is to report any signs of bleeding to their healthcare provider. Bleeding can indicate excessive anticoagulation, which is a serious side effect of warfarin. Prompt reporting of bleeding symptoms is crucial to prevent complications. Choices A, C, and D are incorrect. While avoiding foods high in vitamin K may be important when taking warfarin due to its interaction with the medication, it is not the priority over reporting signs of bleeding. Using a soft toothbrush and electric razor are general precautions for individuals on anticoagulants but are not as critical as reporting bleeding symptoms.

5. A client reports taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. When used for more than 5 days, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion, which is an adverse effect to be assessed in the client. Sedation (choice A) is not a common adverse effect of phenylephrine. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with phenylephrine use.

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