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 healthcare provider is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the healthcare provider monitor?

• A. Urinary retention
• B. Tachypnea
• C. Hypertension
• D. Irritating cough

Correct answer: A

Rationale: The correct answer is urinary retention. Opioid agonists like morphine can suppress the sensation of a full bladder, leading to urinary retention. Monitoring for this complication is crucial to prevent bladder distention and related issues. Choices B, C, and D are incorrect. Tachypnea (increased respiratory rate), hypertension (high blood pressure), and irritating cough are not typically associated with opioid agonist administration for pain management.

3. A client has a prescription for Desmopressin for the treatment of Diabetes Insipidus. Which of the following instructions should the nurse include in the teaching?

• A. Decrease fluid intake at the start of treatment.
• B. Monitor for nocturia.
• C. Report a weight loss of 0.5 kg (1.1 lb) per week.
• D. Expect permanent polyuria with this medication.

Correct answer: A

Rationale: Desmopressin is a medication used to reduce diuresis in clients with diabetes insipidus. To prevent water intoxication, clients should be advised to decrease fluid intake at the beginning of treatment. This instruction helps to balance fluid levels in the body and prevent potential complications associated with excessive fluid intake while on Desmopressin therapy. Monitoring for signs of fluid retention, such as weight gain, and adjusting fluid intake accordingly are essential components of client education when initiating treatment with Desmopressin.

4. What nursing interventions should you perform when a patient is on Albuterol? (Select all that apply)

• A. Assess lung sounds, pulse, and blood pressure before administering
• B. Monitor for changes in behavior
• C. Observe for paradoxical bronchospasms
• D. Both A and C

Correct answer: D

Rationale: The correct nursing interventions to perform when a patient is on Albuterol include assessing the patient's lung sounds, pulse, and blood pressure before administering the medication to monitor for cardiovascular side effects like increased heart rate. Additionally, it is crucial to observe for paradoxical bronchospasms, a rare but serious adverse reaction where the medication causes a worsening of bronchospasm instead of relief. Monitoring for changes in behavior is not directly related to Albuterol administration and is not a standard nursing intervention for patients receiving this medication, making choice B incorrect. Therefore, the correct answer is D as it includes the essential nursing actions for patients on Albuterol.

5. A healthcare provider is educating a client who has a prescription for Theophylline. Which of the following instructions should the healthcare provider include?

• A. Avoid caffeine while taking this medication.
• B. You should increase your fluid intake.
• C. Take this medication in the evening.
• D. You may experience increased appetite while on this medication.

Correct answer: A

Rationale: The correct answer is A: 'Avoid caffeine while taking this medication.' Caffeine can increase the risk of theophylline toxicity as it competes for the same metabolic pathways. Consuming caffeine while on theophylline can lead to adverse effects. Choice B is incorrect because although maintaining adequate hydration is important, it is not a specific instruction related to theophylline use. Choice C is incorrect as the timing of the medication administration should be based on the healthcare provider's recommendation and the client's individual needs. Choice D is incorrect as increased appetite is not a common side effect associated with theophylline.

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