Nursing Elites

1. A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.

2. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

3. What are the actions of the drug metformin?

• A. Decreases hepatic glucose production and intestinal glucose absorption
• B. Increases sensitivity to insulin
• C. Short-term sedation
• D. Both A and B

Correct answer: D

Rationale: Metformin has dual actions by decreasing hepatic glucose production and intestinal glucose absorption, which helps in reducing blood glucose levels. Additionally, it increases sensitivity to insulin, aiding in its proper utilization within the body. Choice A is correct as metformin acts by decreasing hepatic glucose production and intestinal glucose absorption. Choice B is also correct as metformin increases sensitivity to insulin. Choice C, short-term sedation, is incorrect as metformin is not known for causing sedation. Therefore, the correct answer is D because metformin performs both of these actions.

4. A client has been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

5. Which of the following drugs is associated with hepatitis as a reaction?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: C

Rationale: Hepatitis is a known side effect of isoniazid. It is important to monitor patients on isoniazid for signs of liver damage, including hepatitis, as part of their treatment regimen for tuberculosis.

Similar Questions