Nursing Elites

1. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?

• A. Hold Propranolol if the client's apical pulse is greater than 100/min.
• B. Administer Propranolol to decrease the client's blood pressure.
• C. Assist the client with sitting up or standing after taking this medication.
• D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.

Correct answer: C

Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.

2. A client with HIV is beginning therapy with zidovudine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Fatigue
• B. Blurred vision
• C. Ringing in the ears
• D. Constipation

Correct answer: A

Rationale: Fatigue is a common adverse effect of zidovudine due to its impact on bone marrow, leading to anemia. Zidovudine is known to suppress bone marrow function, resulting in decreased production of red blood cells and subsequently causing fatigue due to anemia. Monitoring for fatigue is essential to ensure early detection and management of this adverse effect.

3. A client has a new prescription for Spironolactone. Which of the following findings should the nurse monitor as an adverse effect?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: Corrected Rationale: Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia as an adverse effect. Hyperkalemia can result in muscle weakness and cardiac dysrhythmias, making it essential for the nurse to monitor potassium levels closely when a client is on Spironolactone. Choice B, Hypoglycemia, is incorrect because Spironolactone is not known to cause low blood sugar levels. Choice C, Hypocalcemia, and Choice D, Hyponatremia, are also incorrect as Spironolactone is not associated with decreased levels of calcium or sodium.

4. A client with tobacco use disorder is being educated about Nicotine replacement therapy. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid eating right before chewing a piece of nicotine gum.
• B. I will need to stop using the nicotine gum after 1 year.
• C. I know that nicotine gum is a safe alternative to smoking during pregnancy.
• D. I must chew the nicotine gum quickly for about 15 minutes.

Correct answer: A

Rationale: The correct answer is A. To maximize the effectiveness of nicotine gum, the client should avoid eating or drinking 15 minutes before and while using it. This helps ensure proper absorption of nicotine through the oral mucosa. Choice B is incorrect because the duration of nicotine gum use can vary depending on the individual's needs and progress. Choice C is incorrect as nicotine gum should be used during pregnancy only under healthcare provider guidance. Choice D is incorrect because nicotine gum should be chewed slowly until a tingling sensation is felt, then parked between the cheek and gum until the tingling stops.

5. A client is prescribed Amlodipine. Which of the following adverse effects should the nurse monitor?

• A. Tachycardia
• B. Peripheral edema
• C. Hyperglycemia
• D. Hypertension

Correct answer: B

Rationale: Corrected Rationale: Amlodipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should assess the client for swelling in the lower extremities, a common manifestation of this side effect. Monitoring for peripheral edema is crucial to ensure early detection and appropriate management. Tachycardia (Choice A) is not a common adverse effect of Amlodipine. Hyperglycemia (Choice C) is not typically associated with Amlodipine use. Hypertension (Choice D) is the condition for which Amlodipine is prescribed to treat, not an adverse effect of the medication.

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