Nursing Elites

1. A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?

• A. The development of complaints of insomnia
• B. The development of audible expiratory wheezes
• C. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
• D. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication

Correct answer: B

Rationale: The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.

2. A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?

• A. Lung sounds
• B. Blood pressure
• C. Blood ammonia level
• D. Serum potassium level

Correct answer: C

Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.

3. Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?

• A. Platelet count
• B. Triglyceride level
• C. Complete blood count
• D. White blood cell count

Correct answer: B

Rationale: Before administering Isotretinoin, it is important to check the client's triglyceride levels. Isotretinoin is known to elevate triglyceride levels, hence monitoring them before and periodically during treatment is essential to prevent potential adverse effects.

4. A client is taking ticlopidine hydrochloride (Ticlid). The nurse tells the client to avoid which of the following while taking this medication?

• A. Vitamin C
• B. Vitamin D
• C. Acetaminophen (Tylenol)
• D. Acetylsalicylic acid (aspirin)

Correct answer: D

Rationale: Ticlopidine hydrochloride is a platelet aggregation inhibitor. Aspirin or any aspirin-containing product should be avoided as they can precipitate or aggravate bleeding by affecting platelet function and increasing the risk of bleeding complications.

5. A healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?

• A. Pancreatitis
• B. Pharyngitis
• C. Tonic-clonic seizures
• D. Human immunodeficiency virus (HIV) infection

Correct answer: D

Rationale: Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.

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