Nursing Elites

1. Why is it important to monitor ins and outs in patients using ACE inhibitors?

• A. To assess for renal impairment
• B. To ensure the patient is receiving adequate fluid intake
• C. To assess the patient for potential heart failure
• D. To assess for NSAID use

Correct answer: A

Rationale: It is crucial to monitor ins and outs in patients using ACE inhibitors to assess for renal impairment. ACE inhibitors can affect renal function, potentially leading to renal impairment. Monitoring the patient's fluid balance helps in early recognition of any renal issues and allows for timely interventions to prevent complications.

2. A client has been prescribed Nitroglycerin patches for angina. Which of the following instructions should the nurse include during discharge teaching?

• A. Apply the patch to a different site each time.
• B. Remove the patch for 12 hours each day.
• C. Apply the patch at the same time every day.
• D. Cut the patch in half if your blood pressure is well controlled.

Correct answer: B

Rationale: The correct answer is B: 'Remove the patch for 12 hours each day.' Nitroglycerin patches should be removed for 12 hours each day to prevent the development of tolerance. This nitrate-free interval ensures the medication remains effective in managing angina. Choice A is incorrect because applying the patch to a different site each time is not necessary; it is more important to ensure a nitrate-free interval. Choice C is incorrect because while consistency in timing is good for medication adherence, the crucial aspect for Nitroglycerin patches is the nitrate-free interval. Choice D is incorrect because cutting the patch in half based on blood pressure control is not a recommended practice and could alter the medication's efficacy.

3. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

4. A client has a new prescription for Cyclobenzaprine to treat muscle spasms. Which of the following instructions should the nurse include in the teaching?

• A. Avoid driving or operating heavy machinery while taking this medication.
• B. Take this medication on an empty stomach for best results.
• C. Take this medication only when experiencing muscle pain.
• D. Increase your intake of potassium-rich foods while taking this medication.

Correct answer: A

Rationale: The correct instruction that the nurse should include in the teaching for a client prescribed Cyclobenzaprine is to avoid driving or operating heavy machinery while taking this medication. Cyclobenzaprine can cause drowsiness, so it is important to advise clients to avoid activities that require alertness and coordination to prevent accidents or injuries. Choice B is incorrect because Cyclobenzaprine can be taken with or without food. Choice C is incorrect because Cyclobenzaprine is typically taken regularly as prescribed, not just when experiencing muscle pain. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Cyclobenzaprine.

5. A client with Graves' disease is being educated by a nurse about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heartbeat.
• D. Propranolol promotes a decrease of thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that is commonly used in Graves' disease to decrease symptoms such as tremors and fast heart rate. Choice A is incorrect because Propranolol does not increase blood flow to the thyroid gland. Choice B is incorrect as Propranolol is not used to prevent excess glucose in the blood. Choice D is also incorrect as Propranolol does not directly decrease thyroid hormone levels in the body.

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