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 nurse is providing teaching to a client who has asthma and is beginning to take montelukast. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will use this medication as a rescue inhaler during asthma attacks.
• B. I should take this medication once daily in the evening.
• C. I need to have my blood levels checked regularly while taking this medication.
• D. I should take this medication before exercising to prevent bronchospasm.

Correct answer: B

Rationale: Montelukast is typically taken once daily in the evening for long-term control of asthma symptoms. It helps prevent asthma attacks by reducing inflammation in the airways. While montelukast can also be used for exercise-induced bronchospasm in some cases, it is generally not a rescue medication and should be taken regularly, not on an as-needed basis.

3. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?

• A. Spironolactone
• B. Furosemide
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: A

Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.

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

• A. Take this medication with food.
• B. Take this medication at bedtime.
• C. Take this medication on an empty stomach.
• D. Take this medication with antacids.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach to increase absorption and efficacy. Taking it with food or antacids can interfere with its absorption. By taking Levothyroxine on an empty stomach, the client ensures optimal absorption and effectiveness of the medication.

5. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?

• A. Restrict fluid intake to 1,000 mL per day.
• B. Maintain a consistent sodium intake.
• C. Take the medication at bedtime.
• D. Expect to have frequent headaches.

Correct answer: B

Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.

Similar Questions