Nursing Elites

1. A client is taking Propylthiouracil. For which of the following adverse effects of this medication should the nurse monitor?

• A. Bradycardia
• B. Insomnia
• C. Heat intolerance
• D. Weight loss

Correct answer: A

Rationale: Propylthiouracil is a medication used to treat hyperthyroidism. One of the adverse effects of Propylthiouracil is bradycardia, which is a slower than normal heart rate. Since the medication works by decreasing thyroid hormone production, it can lead to hypothyroidism as a side effect, causing bradycardia. Therefore, the nurse should monitor the client for signs and symptoms of bradycardia while taking Propylthiouracil. Choices B, C, and D are incorrect because insomnia, heat intolerance, and weight loss are not typically associated adverse effects of Propylthiouracil.

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

• A. Take this medication with food.
• B. Avoid dairy products while taking this medication.
• C. Take this medication at bedtime.
• D. Increase your intake of vitamins.

Correct answer: A

Rationale: The correct instruction for a client prescribed Nitrofurantoin is to take the medication with food. Taking Nitrofurantoin with food helps enhance absorption and reduces the risk of gastrointestinal side effects. It is important for the nurse to emphasize this instruction to ensure the client benefits optimally from the medication. Choices B, C, and D are incorrect. Avoiding dairy products is not specifically required with Nitrofurantoin. Taking the medication at bedtime is not a standard instruction. Increasing vitamin intake is not necessary in relation to Nitrofurantoin therapy.

3. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist, such as albuterol, and an inhaled glucocorticoid, such as beclomethasone, for asthma control, the beta2-agonist should be administered first. This sequence is important because the beta2-agonist promotes bronchodilation, which enhances the absorption and effectiveness of the glucocorticoid. Instructing the client to administer the albuterol inhaler before using the beclomethasone inhaler ensures optimal therapeutic benefit. Therefore, option B is the correct choice. Option A is incorrect because the timing of albuterol administration may vary based on the prescribed regimen. Option C is incorrect because beclomethasone is a controller medication, not a rescue medication, and should not be used during acute episodes. Option D is incorrect because beclomethasone should be shaken before use to ensure proper dispersion of the medication.

4. A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?

• A. Varicella vaccine
• B. Rubella vaccine
• C. Inactivated influenza vaccine
• D. Measles vaccine

Correct answer: C

Rationale: The correct answer is C, the inactivated influenza vaccine. During pregnancy, the Centers for Disease Control and Prevention (CDC) recommend the inactivated influenza vaccine as safe for pregnant individuals. This vaccination is crucial to protect both the pregnant person and their developing baby from influenza-related complications. It is essential to avoid live vaccines, such as varicella (chickenpox), rubella, and measles vaccines during pregnancy due to the theoretical risk of harm to the fetus. Choices A, B, and D are incorrect because live vaccines are generally contraindicated during pregnancy.

5. A client is receiving moderate sedation with Diazepam IV and is oversedated. Which of the following medications should the nurse anticipate administering to this client?

• A. Ketamine
• B. Naltrexone
• C. Flumazenil
• D. Fluvoxamine

Correct answer: C

Rationale: Flumazenil is a competitive benzodiazepine antagonist that can reverse the sedative effects of benzodiazepines like Diazepam. In cases of oversedation, administering Flumazenil can help counteract the excessive sedation and other effects of Diazepam, thereby promoting the client's recovery and preventing potential complications. Ketamine (Choice A) is a dissociative anesthetic and not used to reverse benzodiazepine sedation. Naltrexone (Choice B) is an opioid receptor antagonist, not indicated for benzodiazepine oversedation. Fluvoxamine (Choice D) is an antidepressant and not used to reverse the sedative effects of benzodiazepines.

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