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 with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct instruction for the nurse to include when teaching a client with OCD who has a new prescription for Paroxetine is that it can take several weeks before the client feels like the medication is helping. Paroxetine, like other selective serotonin reuptake inhibitors (SSRIs), can take 1 to 4 weeks before the client reaches the full therapeutic benefit. Therefore, it is important to inform the client about this delay in onset of action to manage their expectations and promote adherence to the treatment plan. Choices B, C, and D are incorrect because taking Paroxetine before bedtime is not necessary, it should be taken consistently at the same time each day; Paroxetine is usually taken regularly, not as needed; and while monitoring weight is important, it is not a specific instruction related to the onset of action for Paroxetine.

3. A client has a new prescription for Oxycodone/Acetaminophen, and the nurse is providing discharge instructions. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid taking additional Acetaminophen while on this medication.
• C. Increase your intake of fiber while on this medication.
• D. Avoid taking the medication before bedtime.

Correct answer: B

Rationale: The correct instruction for a client with a prescription for Oxycodone/Acetaminophen is to avoid taking additional Acetaminophen while on this medication. Combining medications containing Acetaminophen can lead to exceeding the maximum recommended dose and increase the risk of liver toxicity. Therefore, it is crucial for the nurse to emphasize the importance of not taking extra Acetaminophen while on this prescription to ensure the client's safety and well-being. Choices A, C, and D are incorrect. Taking Oxycodone/Acetaminophen on an empty stomach is not necessary; increasing fiber intake is not directly related to this medication, and avoiding taking the medication before bedtime is not a specific concern associated with this prescription.

4. A client is prescribed Atorvastatin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin
• D. Sodium

Correct answer: B

Rationale: Creatine kinase should be monitored in clients taking Atorvastatin as it can indicate muscle damage, a serious adverse effect of statins. Elevated creatine kinase levels may suggest myopathy or rhabdomyolysis, which are potential complications of statin therapy.

5. While teaching a client with a new prescription for Warfarin, which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, found in green leafy vegetables, not potassium. The client should avoid consuming large amounts of foods high in vitamin K to maintain the effectiveness of Warfarin therapy. Increasing potassium intake is not a concern related to Warfarin therapy, so this statement indicates a need for further teaching. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding large amounts of green leafy vegetables helps prevent fluctuations in vitamin K levels, taking medication consistently maintains therapeutic levels, and reporting any signs of bleeding is essential for monitoring and managing potential side effects of Warfarin.

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