Nursing Elites

1. A client has a new prescription for Atenolol. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B. Atenolol is a beta-blocker that can cause bradycardia, leading to a decreased heart rate. Monitoring heart rate regularly is essential to detect any significant decreases promptly and seek medical attention. While choices A, C, and D may be relevant to the client's overall health, monitoring heart rate is the priority instruction due to the nature of Atenolol's effects. Taking the medication in the morning can be individualized based on the client's needs and preferences. Avoiding foods high in potassium and increasing fluid intake are generally beneficial but not directly related to managing the side effects of Atenolol.

2. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?

• A. Stop the infusion.
• B. Call the provider.
• C. Elevate the head of the bed.
• D. Auscultate breath sounds.

Correct answer: A

Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.

3. A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?

• A. Remove the prior dose before applying a new dose.
• B. Rub the ointment directly into the skin until it is no longer visible.
• C. Cover the applied ointment with a clean gauze pad.
• D. Apply the ointment to the same skin area each time.

Correct answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.

4. A client is receiving treatment with vincristine. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Neurotoxicity
• C. Neutropenia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for neurotoxicity is crucial to detect any signs early. Choices A, C, and D are incorrect. Hyperkalemia is not a typical finding associated with vincristine. Neutropenia is a common side effect of chemotherapy but is not directly related to vincristine. Bradycardia is not a common adverse effect of vincristine.

5. When starting therapy with bicalutamide, a client should be instructed to monitor for which of the following adverse effects?

• A. Muscle pain
• B. Flushing
• C. Gynecomastia
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Gynecomastia. Bicalutamide, due to its antiandrogenic properties, can lead to gynecomastia in clients. This condition involves the development of breast tissue in males and is an important adverse effect to monitor when taking this medication. Choices A, B, and D are incorrect. Muscle pain and flushing are not commonly associated with bicalutamide use. Hyperglycemia is not a typical adverse effect of bicalutamide therapy.

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