Nursing Elites

1. A client has a new prescription for transdermal nitroglycerin patches. Which of the following instructions should be included for proper use?

• A. Apply the patch to the same site each day.
• B. Place the patch on an area of skin away from skin folds and joints.
• C. Keep the patch on 24 hours per day.
• D. Replace the patch every 72 hours.

Correct answer: B

Rationale: Placing the nitroglycerin patch on an area of skin away from skin folds and joints is crucial to ensure optimal absorption and effectiveness of the medication. Placing the patch on skin folds or joints can interfere with absorption, potentially reducing the patch's efficacy. Therefore, it is essential to follow this instruction to maximize the therapeutic benefits of the nitroglycerin patches. The other options are incorrect because applying the patch to the same site each day can lead to skin irritation, keeping the patch on 24 hours per day may not be necessary depending on the specific patch instructions, and replacing the patch every 72 hours is not the standard frequency for nitroglycerin patches.

2. While assessing a client taking propranolol, which finding should the nurse report to the provider?

• A. Bradycardia
• B. Dry mouth
• C. Constipation
• D. Increased appetite

Correct answer: A

Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.

3. A client with a history of coronary artery disease (CAD) is being discharged after angioplasty. Which instruction should the LPN/LVN reinforce to the client?

• A. You should report any chest pain or discomfort to your health care provider.
• B. Avoid all physical activity for the next 2 weeks.
• C. Return to work immediately after discharge.
• D. Take aspirin only if you experience chest pain.

Correct answer: A

Rationale: The correct instruction to reinforce is to 'Report any chest pain or discomfort to your health care provider.' This is crucial because chest pain post-angioplasty can indicate complications that need immediate attention. Choice A is incorrect because returning to work immediately may not be advisable after angioplasty, as the client needs time to recover. Choice B is incorrect because avoiding all physical activity for 2 weeks may not be necessary; instead, gradual resumption of activities is usually recommended. Choice D is incorrect because aspirin should be taken as prescribed by the healthcare provider, not just when chest pain occurs.

4. A client has a new prescription for digoxin. Which of the following instructions should the nurse include during discharge teaching?

• A. Take the medication with food.
• B. Monitor heart rate daily.
• C. Avoid consuming grapefruit juice.
• D. Increase intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is B: 'Monitor heart rate daily.' When a client is prescribed digoxin, it is essential to monitor heart rate daily because digoxin can cause bradycardia, a condition characterized by a slow heart rate. Monitoring the heart rate regularly allows the client to promptly identify any signs of bradycardia and seek medical attention if needed. Choices A, C, and D are incorrect because taking digoxin with food, avoiding grapefruit juice, and increasing potassium-rich foods are not specific instructions related to managing the side effects or monitoring parameters of digoxin therapy.

5. A client is taking haloperidol. Which of the following findings should the nurse report to the provider?

• A. Weight gain
• B. Dry mouth
• C. Tremors
• D. Tardive dyskinesia

Correct answer: D

Rationale: The correct answer is D: Tardive dyskinesia. Tardive dyskinesia is a serious side effect associated with the long-term use of haloperidol. It is characterized by involuntary movements of the face, tongue, and extremities. Early detection is crucial as tardive dyskinesia may be irreversible and should be reported promptly to the healthcare provider for further evaluation and management. Choices A, B, and C are incorrect because weight gain, dry mouth, and tremors are common side effects of haloperidol but are not as concerning as tardive dyskinesia. While they should still be monitored and managed, tardive dyskinesia requires immediate attention due to its potentially irreversible nature.

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