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 healthcare professional is reviewing the medication list of a client scheduled for surgery. Which of the following medications places the client at risk for increased bleeding during surgery?

• A. Warfarin
• B. Acetaminophen
• C. Ibuprofen
• D. Aspirin

Correct answer: D

Rationale: Aspirin is an anticoagulant that inhibits platelet function, increasing the risk of bleeding during surgery. It is important for the healthcare professional to identify this medication, inform the surgical team, and consider withholding it prior to surgery to reduce the risk of excessive bleeding. Warfarin is also an anticoagulant but can be managed by adjusting the dosage or monitoring INR levels. Acetaminophen and ibuprofen are not associated with increased bleeding risk as they do not affect platelet function like aspirin.

3. A client has a prescription for Prednisone for the treatment of Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will increase my intake of potassium-rich foods.
• B. I should take my medication with food.
• C. I will decrease my intake of calcium-rich foods.
• D. I should avoid eating grapefruit while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Prednisone can cause hypokalemia, leading to low potassium levels. Increasing the intake of potassium-rich foods helps prevent this imbalance. Choices B, C, and D are incorrect because taking Prednisone with food, decreasing calcium-rich foods, or avoiding grapefruit are not specifically related to addressing the side effect of hypokalemia associated with Prednisone.

4. A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?

• A. aPTT of 90 seconds
• B. Platelet count of 150,000/mm³
• C. INR of 1.0
• D. Hgb of 15 g/dL

Correct answer: A

Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.

5. A client has a new prescription for Ondansetron for nausea and vomiting associated with chemotherapy. Which of the following statements should the nurse include?

• A. Take this medication one hour before chemotherapy.
• B. You may experience a headache while taking this medication.
• C. Increase your intake of potassium while taking this medication.
• D. This medication may cause temporary hearing loss.

Correct answer: B

Rationale: The correct statement the nurse should include is that the client may experience a headache while taking Ondansetron. Headache is a common side effect of this medication, and clients need to be informed about this potential adverse reaction to enhance their understanding and management of side effects. The other statements are incorrect because Ondansetron is usually taken 30 minutes before chemotherapy, not one hour before (choice A). There is no specific need to increase potassium intake while taking Ondansetron (choice C), and temporary hearing loss is not a common side effect associated with this medication (choice D).

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