Nursing Elites

1. In reviewing a client's health record, which condition would be a contraindication for using Propranolol to treat hypertension?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blocking beta2 receptors in the lungs can lead to bronchoconstriction, making it unsuitable for clients with asthma. Therefore, asthma is a contraindication for taking Propranolol. Glaucoma, hypertension, and tachycardia are not contraindications for using Propranolol to treat hypertension.

2. A healthcare professional is obtaining a medication history from a client who is to receive Imipenem-cilastatin IV to treat an infection. Which of the following medications the client also receives puts them at risk for a medication interaction?

• A. Regular insulin
• B. Furosemide
• C. Valproic acid
• D. Ferrous sulfate

Correct answer: C

Rationale: The correct answer is C, Valproic acid. Imipenem-cilastatin decreases the blood levels of valproic acid, an antiseizure medication, which can lead to increased seizure activity. Monitoring and adjusting the dosage of valproic acid may be necessary when co-administered with Imipenem-cilastatin to prevent adverse effects. Choices A, B, and D do not typically interact significantly with Imipenem-cilastatin and are not associated with a high risk of adverse interactions in this scenario.

3. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?

• A. Bony orbit
• B. Nasolacrimal duct
• C. Conjunctival sac
• D. Outer canthus

Correct answer: B

Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.

4. A client has a new prescription for Clonidine. What instruction should the nurse include during teaching?

• A. Take the medication with food.
• B. Expect to feel drowsy or lightheaded.
• C. Increase your fluid intake.
• D. Avoid foods high in fat.

Correct answer: B

Rationale: The correct instruction when teaching a client about Clonidine is to expect to feel drowsy or lightheaded. Clonidine can cause these side effects, especially when starting the medication. The nurse should advise the client to avoid activities that require alertness until they understand how the medication affects them. Choices A, C, and D are incorrect because taking Clonidine with food, increasing fluid intake, or avoiding foods high in fat are not specific instructions related to managing the side effects of Clonidine.

5. When educating a client starting a new prescription for simvastatin, which instruction should the nurse provide?

• A. Take the medication in the morning.
• B. Report any muscle pain immediately.
• C. Avoid taking the medication with grapefruit juice.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct instruction for a client starting simvastatin is to report any muscle pain immediately because it could be indicative of rhabdomyolysis, a serious side effect of the medication. This prompt reporting can help prevent further complications and ensure timely medical intervention. Choice A is incorrect because simvastatin can be taken at any time of the day. Choice C is generally true for many medications, but there is no specific interaction between grapefruit juice and simvastatin. Choice D is also incorrect as there is no specific recommendation to take simvastatin at bedtime.

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