Nursing Elites

1. A client is to receive Tetracaine before a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

• A. Keep the client NPO until the pharyngeal response returns.
• B. Monitor the insertion site for a hematoma.
• C. Palpate the bladder to detect urinary retention.
• D. Maintain the client on bed rest for 12 hours following the procedure.

Correct answer: A

Rationale: The correct action for the nurse to include in the plan of care is to keep the client NPO until the pharyngeal response returns. Tetracaine can affect the gag reflex, so it is important to prevent aspiration by maintaining the client NPO until the pharyngeal response is normal, which typically takes about 1 hour. Monitoring for the return of the gag reflex is crucial to prevent complications from aspiration during the first oral intake after the procedure. Choices B, C, and D are incorrect because they are not directly related to the effects of Tetracaine or the bronchoscopy procedure.

2. A client with HIV-1 infection is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Cardiac dysrhythmia
• B. Metabolic alkalosis
• C. Renal failure
• D. Aplastic anemia

Correct answer: D

Rationale: Corrected Rationale: Zidovudine is associated with the development of aplastic anemia, a serious adverse effect characterized by bone marrow suppression. Regular monitoring is essential to detect this side effect early and prevent complications. Cardiac dysrhythmia, metabolic alkalosis, and renal failure are not commonly associated with zidovudine use, making them incorrect choices for adverse effects of this medication.

3. A healthcare provider is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?

• A. Lowered heart rate
• B. Increased myocardial contractility
• C. Decreased conduction through the AV node
• D. Vasoconstriction of renal blood vessels

Correct answer: B

Rationale: Dopamine, when administered at a low dose, acts on beta1 receptors in the heart, leading to increased myocardial contractility. This positive inotropic effect results in improved cardiac output, which is beneficial for a client with severe heart failure. Dopamine does not typically cause lowered heart rate, decreased conduction through the AV node, or vasoconstriction of renal blood vessels at low doses.

4. A healthcare provider is reviewing the health history of a client who has a prescription for Propranolol. Which of the following findings should the provider report?

• A. Previous history of thromboembolism
• B. Concurrent use of an antacid
• C. History of bronchial asthma
• D. Recent weight gain

Correct answer: C

Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with a history of bronchial asthma. Reporting a history of bronchial asthma to the provider is crucial as it would prompt a review of the medication prescription to avoid potential adverse effects and consider alternative treatment options.

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

• A. Rinse your mouth after each use of this medication.
• B. Limit fluid intake while taking this medication.
• C. Increase your intake of vitamin B12 while taking this medication.
• D. You can take the medication as needed.

Correct answer: A

Rationale: The correct instruction the nurse should provide is to rinse the mouth after each use of Beclomethasone. This practice helps reduce the risk of developing oral fungal infections associated with inhaled corticosteroids. Choice B is incorrect because there is no need to limit fluid intake while taking this medication. Choice C is incorrect as there is no specific indication to increase vitamin B12 intake with Beclomethasone. Choice D is incorrect as Beclomethasone should be used according to the prescribed schedule, not as needed.

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