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. A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?

• A. Apply the patch to a hairless area of the body.
• B. Remove the patch every 12 hours.
• C. Massage the patch after applying it.
• D. Place the patch over a hairless area of the body.

Correct answer: D

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.

3. When reviewing facility policies for IV therapy with the team, a nurse manager should remind the team that which technique helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: Avoiding reinserting the needle into an IV catheter is crucial to minimizing the risk of catheter embolism. Reinserting the needle can lead to the severing of the catheter's end, potentially causing a catheter embolism, a serious complication. The other options, while important for IV therapy safety, are not directly related to preventing catheter embolism.

4. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: A

Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers, such as the one the client received. It works by inhibiting the breakdown of acetylcholine, thereby enhancing neuromuscular transmission and reversing muscle weakness caused by the neuromuscular blocking agent.

5. A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?

• A. Take the medication before bed.
• B. Monitor for increased blood pressure.
• C. Take the medication on an empty stomach.
• D. Monitor for leg cramps.

Correct answer: D

Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.

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