Nursing Elites

1. A healthcare professional is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare professional plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 min.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hr of manifestation onset.

Correct answer: B

Rationale: The correct intervention when administering IV Alteplase is to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This helps prevent bleeding complications associated with thrombolytic therapy. Administering IM Enoxaparin is not indicated with Alteplase, as it is an anticoagulant rather than a thrombolytic agent. Aminocaproic acid is not typically administered prior to alteplase infusion in the context of a massive Pulmonary Embolism. While timely administration of Alteplase is important, the specific timeframe within which it should be administered may vary based on the clinical situation, so a strict 8-hour window is not universally applicable.

2. A client is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

• A. Decreased blood pressure
• B. Increase in HDL cholesterol
• C. Prevention of bipolar manic episodes
• D. Improved sexual function

Correct answer: A

Rationale: The therapeutic effect of lisinopril, an ACE inhibitor, is indicated by a decrease in blood pressure. Lisinopril works by relaxing blood vessels, leading to a reduction in blood pressure. Monitoring and achieving a decrease in blood pressure is a key outcome when managing hypertension with lisinopril. Choices B, C, and D are incorrect because lisinopril is not intended to increase HDL cholesterol, prevent bipolar manic episodes, or improve sexual function. Therefore, the correct outcome indicating the therapeutic effect of lisinopril is a decrease in blood pressure.

3. When providing teaching to a client with a prescription for Hydrochlorothiazide, which instruction should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid foods high in potassium.
• C. Take this medication on an empty stomach.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct instruction for a client prescribed Hydrochlorothiazide is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalance, potentially causing dehydration. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. Therefore, it is essential for the client to be vigilant in recognizing these symptoms and seek medical attention if they occur. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide at bedtime is not a specific instruction related to its effects or side effects. Avoiding foods high in potassium may be necessary for some medications, but it is not the primary concern with Hydrochlorothiazide. Taking this medication on an empty stomach is not a requirement and may vary depending on individual preferences or healthcare provider instructions.

4. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Paroxetine, an antidepressant commonly used for OCD, typically takes 1 to 4 weeks before the client experiences the full therapeutic benefit. Therefore, informing the client that it may take several weeks before feeling the medication's effects is crucial to manage expectations and ensure compliance with the treatment plan. Choice B is incorrect because Paroxetine is usually taken in the morning due to its activating effects and may cause insomnia if taken before bedtime. Choice C is incorrect because Paroxetine should be taken regularly as prescribed, not just when experiencing obsessive urges. Choice D is incorrect because although weight gain can be a side effect of Paroxetine, it is not a priority instruction compared to the delayed onset of therapeutic effects.

5. A client has a new prescription for Labetalol. Which of the following instructions should be included?

• A. Take this medication at bedtime.
• B. Avoid sudden discontinuation of the medication.
• C. Increase your intake of sodium-rich foods.
• D. Avoid drinking grapefruit juice.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid sudden discontinuation of Labetalol. Abrupt discontinuation of beta-blockers like Labetalol can lead to rebound hypertension and other cardiac issues. It is important for clients to taper off the medication under healthcare provider guidance to prevent potential complications.

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