Nursing Elites

1. A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?

• A. Administer the medication as prescribed
• B. Administer half of the normal dose
• C. Consider the extended-release form of the medication
• D. Withhold administration of the medication and notify the healthcare provider

Correct answer: D

Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.

2. A client is starting therapy with Atenolol. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hypoglycemia
• C. Bradycardia
• D. Hypertension

Correct answer: C

Rationale: Atenolol is a beta-blocker that can cause bradycardia as an adverse effect due to its mechanism of action in slowing down the heart rate. The nurse should instruct the client to monitor their pulse regularly and report any significant decreases to prevent complications related to bradycardia.

3. When teaching a client with schizophrenia strategies to cope with anticholinergic effects of Fluphenazine, which of the following should the nurse suggest to minimize anticholinergic effects?

• A. Take the medication in the morning to prevent insomnia.
• B. Chew sugarless gum to moisten the mouth.
• C. Use cooling measures to decrease fever.
• D. Take an antacid to relieve nausea.

Correct answer: B

Rationale: The correct answer is B: 'Chew sugarless gum to moisten the mouth.' Chewing sugarless gum can help alleviate dry mouth, which is a common anticholinergic effect of Fluphenazine. Dry mouth can be uncomfortable and affect the client's oral health. Options A, C, and D are incorrect because they do not directly address anticholinergic effects. Taking the medication in the morning to prevent insomnia (Option A) is unrelated to anticholinergic effects. Using cooling measures to decrease fever (Option C) is not a common anticholinergic effect of Fluphenazine. Taking an antacid to relieve nausea (Option D) does not specifically target anticholinergic effects.

4. A client is starting therapy with docetaxel. Which of the following findings should the nurse instruct the client to report?

• A. Flushing
• B. Dyspnea
• C. Hyperglycemia
• D. Tinnitus

Correct answer: B

Rationale: The correct answer is B: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a serious adverse effect of docetaxel. Dyspnea may be a sign of a potentially life-threatening condition that the healthcare provider needs to address promptly. Flushing (Choice A) is not typically associated with docetaxel therapy. Hyperglycemia (Choice C) is also not a common side effect of docetaxel. Tinnitus (Choice D) is not a usual finding with docetaxel and is not a priority over potential pulmonary toxicity indicated by dyspnea.

5. When educating a client with a new prescription for Enalapril, which manifestation should the nurse instruct the client to report as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors, such as enalapril. This cough can be bothersome and may indicate the need for a medication adjustment. It is crucial for the client to report this symptom to their healthcare provider to explore potential alternatives or adjustments to the treatment plan. Tremors, drowsiness, and hyperactivity are not commonly associated with enalapril and are less likely to be attributed to this medication.

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