Nursing Elites

1. A client has been prescribed Prednisone for an inflammatory condition and is receiving discharge teaching from a nurse. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Avoid alcohol while taking this medication.
• C. Monitor your blood pressure regularly.
• D. Take this medication in the morning to prevent insomnia.

Correct answer: D

Rationale: The correct answer is to take Prednisone in the morning to prevent insomnia. Prednisone can cause insomnia as a side effect, so taking it in the morning can help minimize this issue. It is important to follow the healthcare provider's instructions regarding the timing of Prednisone administration to optimize its effectiveness and minimize adverse effects.

2. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Remove the nitroglycerin patch for 30 minutes if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each evening to prevent tolerance. This allows for a nitrate-free period of 10 to 12 hours during each 24-hour period, reducing the risk of developing tolerance to the medication. Choice B is incorrect because cutting the patch could alter the dose delivery and is not recommended. Choice C is incorrect as removing the patch for 30 minutes when a headache occurs may not be effective in managing symptoms. Choice D is incorrect as Nitroglycerin patches are usually applied once daily, not every 48 hours.

3. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV Nitroprusside is infused at high dosages, it can lead to thiocyanate toxicity, causing mental status changes such as delirium. It is crucial to monitor the thiocyanate levels to ensure they remain below 10 mg/dL during therapy to prevent adverse effects. Choices A, B, and D are incorrect because IV Nitroprusside is not commonly associated with intestinal ileus, neutropenia, or hyperthermia. Monitoring for delirium is crucial due to the risk of thiocyanate toxicity.

4. A client will start Alfuzosin for the treatment of Benign Prostatic Hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication?

• A. Bradycardia
• B. Edema
• C. Hypotension
• D. Tremor

Correct answer: C

Rationale: The correct answer is C, Hypotension. Alfuzosin relaxes muscle tone in veins, leading to vasodilation and reduced systemic vascular resistance. This effect can cause hypotension due to decreased cardiac output. Clients should be advised to rise slowly from a sitting or lying position to minimize the risk of orthostatic hypotension. Choices A, B, and D are incorrect because bradycardia, edema, and tremor are not commonly associated adverse effects of Alfuzosin.

5. A client has a new prescription for Atenolol. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B. Atenolol is a beta-blocker that can cause bradycardia, leading to a decreased heart rate. Monitoring heart rate regularly is essential to detect any significant decreases promptly and seek medical attention. While choices A, C, and D may be relevant to the client's overall health, monitoring heart rate is the priority instruction due to the nature of Atenolol's effects. Taking the medication in the morning can be individualized based on the client's needs and preferences. Avoiding foods high in potassium and increasing fluid intake are generally beneficial but not directly related to managing the side effects of Atenolol.

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