Nursing Elites

1. A client has a new prescription for Propranolol. Which of the following findings should be identified as a contraindication to this medication?

• A. Asthma
• B. Diabetes mellitus
• C. Hypertension
• D. Glaucoma

Correct answer: A

Rationale: Corrected Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with asthma. Asthma is a contraindication due to the potential for worsening bronchoconstriction and exacerbating respiratory symptoms. Choice B, diabetes mellitus, is not a contraindication for Propranolol. Choice C, hypertension, is actually an indication for Propranolol as it is commonly used to treat hypertension. Choice D, glaucoma, is not a contraindication for Propranolol use.

2. Which of the following drugs is associated with Stevens-Johnson syndrome?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: D

Rationale: Stevens-Johnson syndrome is a severe skin reaction that can be associated with Ethosuximide.

3. What is a desired outcome of the drug Phenytoin?

• A. Decrease symptoms of PTSD
• B. Resolution of signs of infection
• C. Decrease or cessation of seizures without excessive sedation
• D. Prevention or relief of bronchospasm

Correct answer: C

Rationale: The correct answer is C: Decrease or cessation of seizures without excessive sedation. Phenytoin is primarily used as an antiepileptic medication to manage and prevent seizures. It does not directly impact symptoms of PTSD (Choice A), resolution of signs of infection (Choice B), or prevention or relief of bronchospasm (Choice D). Therefore, the desired outcome of Phenytoin is to control seizures effectively while avoiding excessive sedation.

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

• A. Notify the provider if you plan to become pregnant.
• B. Take the medication 1 hour before planning to go to sleep.
• C. Allow at least 6 hours for sleep when taking zolpidem.
• D. Do not take zolpidem with a bedtime snack.

Correct answer: A

Rationale: Zolpidem is classified as Pregnancy Risk Category C. It is important for the client to inform the provider if they plan to become pregnant because the medication may need to be adjusted or changed to ensure the safety of the fetus. This communication allows for appropriate monitoring and adjustments to be made to the treatment plan. Choice B is incorrect because zolpidem should be taken just before going to bed, not specifically 1 hour before. Choice C is incorrect as zolpidem is a short-acting medication, and it does not require a full 6 hours for sleep. Choice D is incorrect because zolpidem can be taken with or without food, so taking it with a bedtime snack is not contraindicated.

5. A client is receiving Morphine IV for pain management. Which of the following actions should the nurse take to monitor for adverse effects?

• A. Monitor the client's respiratory rate every 15 minutes.
• B. Monitor the client's blood pressure every 30 minutes.
• C. Monitor the client's oxygen saturation every hour.
• D. Monitor the client's heart rate every 5 minutes.

Correct answer: A

Rationale: The correct action for the nurse to monitor for adverse effects of Morphine IV is to check the client's respiratory rate every 15 minutes. Respiratory depression is a potentially life-threatening adverse effect of Morphine. Monitoring the respiratory rate frequently allows for early detection and intervention if needed. Monitoring blood pressure, oxygen saturation, or heart rate alone may not provide early signs of respiratory depression, which is a critical adverse effect of Morphine IV.

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