Nursing Elites

1. 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.

2. Which drug classes are NOT typically used to treat angina?

• A. Calcium channel blockers
• B. Organic nitrates
• C. Alpha blockers
• D. Beta blockers

Correct answer: C

Rationale: Angina is primarily treated with calcium channel blockers, organic nitrates, and beta blockers. Alpha blockers are not commonly used in the treatment of angina. Calcium channel blockers help dilate blood vessels, decreasing the workload on the heart. Organic nitrates relax and widen blood vessels, improving blood flow and reducing the heart's workload. Beta blockers reduce the heart rate and blood pressure, decreasing the heart's demand for oxygen. Alpha blockers are more commonly used to treat conditions like hypertension and benign prostatic hyperplasia.

3. A client has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. After more than 5 days of use, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion. This occurs due to prolonged vasoconstriction of nasal blood vessels, causing worsening nasal congestion. Sedation (choice A) is not a common adverse effect of phenylephrine nasal drops. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with this medication.

4. A healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

5. A client with a history of preterm labor is reviewing a new prescription for Terbutaline. Which of the following client statements indicates understanding of the teaching?

• A. I will increase my daily fluid intake to 3 quarts.
• B. I can increase my activity now that I've started on this medication.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor. This response demonstrates the client's understanding of the importance of monitoring contractions and seeking appropriate medical attention. Choices A, B, and D are incorrect because increasing fluid intake, increasing activity, or assuming the medication will prevent preterm labor are not relevant actions in managing preterm labor or taking Terbutaline.

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