Nursing Elites

1. A nurse is caring for a client with hypertension who asks about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients with a history of which of the following conditions?

• A. Asthma
• B. Glaucoma
• C. Depression
• D. Migraines

Correct answer: A

Rationale: Corrected Rationale: Propranolol is contraindicated in clients with a history of asthma because it can cause bronchospasms due to its non-selective beta-blocking properties. By blocking beta-2 receptors in the lungs, propranolol can lead to bronchoconstriction, potentially triggering asthma symptoms and exacerbating respiratory issues. Asthma patients should avoid medications like propranolol that can worsen their condition. Choices B, C, and D are incorrect as propranolol is not contraindicated in clients with glaucoma, depression, or migraines. In fact, propranolol is sometimes used in the treatment of migraines and certain types of glaucoma.

2. What is the primary use of lithium?

• A. Lower blood glucose
• B. Slow the heart rate
• C. Stabilize mood
• D. Heal ulcers

Correct answer: C

Rationale: The correct answer is C: Stabilize mood. Lithium is primarily used to stabilize mood, especially in conditions like bipolar disorder. It helps in reducing the frequency and severity of manic episodes, making it an essential medication for mood stabilization. Choices A, B, and D are incorrect as lithium is not used to lower blood glucose, slow the heart rate, or heal ulcers.

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

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

Correct answer: B

Rationale: The correct instruction is to avoid drinking grapefruit juice when taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the drug and potentially causing adverse effects like cardiac toxicity. Choices A, C, and D are incorrect because taking Amiodarone with meals, at bedtime, or increasing sodium-rich foods intake are not relevant instructions for this medication.

4. What is one therapeutic use for nitroglycerin?

• A. Relief or prevention of anginal attacks
• B. Diuresis and mobilization of excess fluid
• C. Decreasing nausea and vomiting
• D. Relief of anxiety

Correct answer: A

Rationale: Nitroglycerin is primarily used for the relief or prevention of anginal attacks. It works by dilating blood vessels, increasing blood flow and oxygen to the heart muscle, thereby relieving chest pain caused by angina. The medication is not indicated for diuresis, antiemetic effects, or anxiety relief. Therefore, choices B, C, and D are incorrect as they do not reflect the therapeutic use of nitroglycerin.

5. A client with Angina Pectoris asks the nurse about the next step if they take one tablet, wait 5 minutes, but still have Anginal pain. Which response should the nurse provide?

• A. Take two more sublingual tablets at the same time.
• B. Call emergency services.
• C. Take a sustained-release nitroglycerin capsule.
• D. Wait another 5 minutes then take a second sublingual tablet.

Correct answer: B

Rationale: If anginal pain persists after taking the first tablet and waiting 5 minutes, the priority step is to call emergency services (911) and then take a second sublingual tablet. Persistent pain could indicate a myocardial infarction, and immediate medical attention is crucial. Taking two more tablets at the same time (Choice A) can lead to excessive vasodilation and hypotension. Taking a sustained-release nitroglycerin capsule (Choice C) is not appropriate for immediate relief during an acute episode. Waiting another 5 minutes and then taking a second tablet (Choice D) is not advisable in this emergency situation where prompt action is necessary.

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