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 has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

• A. I will clean the site with an alcohol swab before applying the patch.
• B. I will rotate the application sites weekly.
• C. I will apply the patch to an area of skin with no hair.
• D. I will place the new patch where the old patch was.

Correct answer: C

Rationale: The correct answer is C because applying the patch to an area of skin without hair ensures better absorption of the medication. Hair can interfere with the patch's adherence and effectiveness. It is important for the client to choose a clean, hairless area for proper medication delivery. Choices A, B, and D are incorrect. Cleaning the site with an alcohol swab is a good practice but does not specifically indicate understanding of proper patch application. Rotating application sites weekly is important to prevent skin irritation but is not directly related to applying the patch to an area of skin without hair. Placing the new patch where the old patch was may lead to skin irritation and poor absorption of the medication.

3. A nurse is providing instructions to a client who has a prescription for Amoxicillin and Clarithromycin to treat a Peptic Ulcer. Which of the following information should the nurse include in the teaching?

• A. Take these medications with foo '
• B. These medications can turn your stool black.'
• C. These medications can cause photosensitivity.'
• D. The purpose of these medications is to decrease the pH of gastric juices in the stomach.'

Correct answer: A

Rationale: The nurse should instruct the client to take these medications with food to reduce GI disturbances.

4. A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: To minimize the risk of catheter embolism, it is crucial to avoid reinserting the needle into an IV catheter. This practice can potentially sever the end of the catheter, leading to catheter embolism. Proper insertion techniques, securement, and avoiding unnecessary manipulations of the catheter can help prevent this serious complication.

5. Which of the following is not a common effect of Midazolam?

• A. Amnesia
• B. Decreased respiratory function
• C. Anesthetic
• D. Dizziness

Correct answer: D

Rationale: Midazolam is a benzodiazepine commonly used for its sedative, anxiolytic, and amnestic effects. While dizziness can be a side effect of Midazolam, it is not a primary or common effect. Therefore, the correct answer is D, as it deviates from the typical effects associated with Midazolam.

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