Nursing Elites

1. A client with increased intracranial pressure is receiving Mannitol. Which finding should the nurse report to the provider?

• A. Blood glucose 150 mg/dL
• B. Urine output 40 mL/hr
• C. Dyspnea
• D. Bilateral equal pupil size

Correct answer: C

Rationale: The correct answer is C: Dyspnea. Dyspnea is a concerning finding in a client receiving Mannitol as it can be a manifestation of heart failure, which is an adverse effect of the medication. The nurse should promptly notify the provider, discontinue the Mannitol, and initiate appropriate interventions to address the dyspnea and monitor the client's condition closely. Choice A, Blood glucose of 150 mg/dL, is within normal limits and not directly related to Mannitol administration. Choice B, Urine output of 40 mL/hr, could indicate decreased renal perfusion, but it is not the most critical finding compared to dyspnea. Choice D, Bilateral equal pupil size, is a normal neurological finding and not directly related to Mannitol therapy.

2. A nurse is providing teaching to a client who has a new prescription for Metoprolol. Which of the following statements should the nurse include?

• A. This medication may make you feel dizzy at first.
• B. You should avoid foods that are high in fat.
• C. Take the medication in the morning.
• D. You may experience a rapid heart rate while taking this medication.

Correct answer: A

Rationale: Metoprolol, a beta-blocker, can cause dizziness, especially when starting the medication. The nurse should inform the client to change positions slowly to avoid dizziness and falls.

3. A client is to receive Tetracaine prior to a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

• A. Keep the client NPO until the pharyngeal response returns.
• B. Monitor the insertion site for a hematoma.
• C. Palpate the bladder to detect urinary retention.
• D. Maintain the client on bed rest for 12 hours following the procedure.

Correct answer: A

Rationale: The correct action the nurse should include in the plan of care is to keep the client NPO until the pharyngeal response returns. This is important to prevent aspiration until the client's normal pharyngeal sensation is restored, typically within about 1 hour after the procedure. Monitoring the insertion site for a hematoma, palpating the bladder, and maintaining the client on bed rest are not directly related to the administration of Tetracaine prior to a Bronchoscopy. Therefore, these actions are not necessary in the immediate post-procedure care of a client receiving Tetracaine for a Bronchoscopy.

4. When educating a client with a new prescription for Losartan, which instruction should the nurse provide?

• A. Avoid consuming grapefruit juice.
• B. Take this medication with a full glass of water.
• C. Take this medication with food.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct answer is to instruct the client to monitor for signs of dehydration when taking Losartan. Losartan can lead to dehydration, so it is crucial for the client to watch out for symptoms like dry mouth, increased thirst, and reduced urine output. Monitoring for these signs can help prevent complications associated with dehydration while taking this medication. Choices A, B, and C are incorrect because Losartan is not known to have interactions with grapefruit juice, does not require a specific amount of water for intake, and can be taken with or without food.

5. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: The correct answer is C, Regular insulin. Regular insulin, also known as short-acting insulin, typically exhibits a peak effect around 1 to 5 hours following administration. This rapid onset and peak effect make it suitable for managing postprandial glucose levels. Insulin glargine is a long-acting insulin with no pronounced peak effect, making it unsuitable for rapid glucose control within 1 to 5 hours. NPH insulin has an intermediate duration of action and a different peak time frame. Insulin lispro is a rapid-acting insulin that peaks within 30 minutes to 2.5 hours after administration, not within the 1 to 5-hour range.

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