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. 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.

3. A client in a critical care unit is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?

• A. Prone
• B. On the nonoperative side
• C. Sims'
• D. Semi-Fowler's

Correct answer: D

Rationale: After a pneumonectomy, positioning the client in a semi-Fowler's position is crucial for optimal ventilation. This position helps improve lung expansion on the remaining side, facilitating better oxygenation and preventing complications like atelectasis. Placing the client prone, on the nonoperative side, or in Sims' position would not provide the same respiratory benefits post-pneumonectomy.

4. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include in the discharge teaching?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct instruction for Nitroglycerin sublingual tablets is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. This regimen helps in relieving angina symptoms effectively. Option A of taking one tablet every 15 minutes is too infrequent and may delay symptom relief. Option C of taking one tablet at bedtime is not appropriate as Nitroglycerin is used for immediate relief of angina. Option D of taking one tablet on an empty stomach is irrelevant since Nitroglycerin is not affected by food intake.

5. What is the pharmacological class of Lithium?

• A. Antidiabetics, biguanides
• B. Mood stabilizers
• C. Antiarrhythmics, anticonvulsants
• D. Vascular headache suppressants

Correct answer: B

Rationale: Lithium is classified as a mood stabilizer due to its primary use in managing bipolar disorder, where it helps stabilize mood swings and prevent episodes of mania and depression. While it can have other effects on the body, its main therapeutic role lies in its mood-stabilizing properties. Choices A, C, and D are incorrect as lithium is not classified as antidiabetics, biguanides, antiarrhythmics, anticonvulsants, or vascular headache suppressants. Its main pharmacological class is mood stabilizers.

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