Nursing Elites

1. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

2. A client has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?

• A. Orthostatic hypotension
• B. Increased heart rate
• C. Dark-colored urine
• D. Persistent cough

Correct answer: B

Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.

3. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

• A. Furosemide
• B. Captopril
• C. Ranolazine
• D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients experiencing tachycardia, including those with reflex tachycardia induced by medications like Isosorbide Mononitrate. Furosemide (Choice A) is a diuretic and is not indicated for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor used for hypertension and heart failure, not tachycardia. Ranolazine (Choice C) is used in chronic angina but does not address tachycardia.

4. A client has a new prescription for Ciprofloxacin. Which of the following instructions should the nurse include?

• A. Take this medication with meals.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking this medication with dairy products.' Ciprofloxacin should not be taken with dairy products because calcium can interfere with the absorption of the medication. Instructing the client to take it 1 hour before or 2 hours after consuming dairy products will ensure optimal effectiveness of the medication. Choice A is incorrect because Ciprofloxacin is usually recommended to be taken on an empty stomach or with a full glass of water. Choice C is incorrect as there is no specific requirement to take Ciprofloxacin at bedtime. Choice D is also incorrect as there is no need to increase intake of potassium-rich foods in relation to taking Ciprofloxacin.

5. What is the therapeutic use of metformin?

• A. Lower blood pressure
• B. Diminish seizure activity
• C. The maintenance of a person's blood glucose levels
• D. Increase heart rate and decrease gastrointestinal secretions

Correct answer: C

Rationale: Metformin is commonly prescribed to manage and control blood glucose levels in individuals with diabetes. It helps in reducing the amount of glucose produced by the liver and improves the body's response to insulin, thereby aiding in the regulation of blood sugar levels. It is not used to lower blood pressure, diminish seizure activity, increase heart rate, or decrease gastrointestinal secretions.

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