Nursing Elites

1. A client has a new prescription for Propranolol. Which of the following statements should the nurse include in teaching the client?

• A. You may experience a rapid heart rate while taking this medication.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Increase your intake of high-sodium foods.

Correct answer: C

Rationale: The correct statement to include when teaching a client about Propranolol is to avoid sudden changes in position. Propranolol, a beta-blocker, can lead to dizziness and lightheadedness, particularly when changing positions. Therefore, clients should be advised to change positions slowly to prevent falls and related injuries. Choice A is incorrect because Propranolol actually helps lower heart rate and blood pressure. Choice B is not a specific requirement for taking Propranolol. Choice D is also incorrect as increasing high-sodium foods is not recommended with Propranolol which can affect blood pressure control.

2. A client has a new prescription for a combination of oral NRTIs (abacavir, lamivudine, and zidovudine) for the treatment of HIV. Which of the following statements should the nurse include in teaching the client?

• A. These medications work by blocking HIV entry into cells.
• B. These medications work by weakening the cell wall of the HIV virus.
• C. These medications work by inhibiting enzymes to prevent HIV replication.
• D. These medications work by preventing protein synthesis within the HIV cell.

Correct answer: C

Rationale: The NRTI antiretroviral medications this client is prescribed work by inhibiting the enzyme reverse transcriptase, thus preventing HIV replication. By inhibiting this crucial enzyme, the drug interferes with the virus's ability to replicate and spread in the body. Choice A is incorrect because NRTIs do not block HIV entry into cells. Choice B is incorrect as NRTIs do not weaken the cell wall of the virus. Choice D is incorrect as NRTIs do not prevent protein synthesis within the HIV cell.

3. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?

• A. BUN
• B. Creatinine
• C. Hemoglobin
• D. White blood cell count

Correct answer: B

Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.

4. A client has a prescription for a Nicotine transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch at the same time each day.
• B. Remove the patch at bedtime.
• C. Apply the patch to the same location daily.
• D. Place the patch over an area of the body with hair.

Correct answer: A

Rationale: The correct instruction for a client using a Nicotine transdermal patch is to apply the patch at the same time each day. This helps maintain consistent blood levels of nicotine throughout the treatment period, which can aid in reducing cravings for smoking. Consistency in the application time is essential for the effectiveness of the patch. Choices B, C, and D are incorrect. Removing the patch at bedtime may disrupt the continuous delivery of nicotine, applying the patch to the same location daily can cause skin irritation, and placing the patch over an area with hair may affect its adhesion and absorption.

5. What is the primary action of warfarin as an anticoagulant?

• A. Prevents the formation of blood clots
• B. Dissolves existing blood clots
• C. Dilates coronary arteries
• D. Treats rhythm disturbances

Correct answer: A

Rationale: The correct answer is A: "Prevents the formation of blood clots." Warfarin acts as an anticoagulant by inhibiting the synthesis of certain clotting factors in the liver. This action reduces the blood's ability to clot, making it effective in preventing the formation of blood clots. Choice B is incorrect because warfarin does not dissolve existing blood clots; it prevents their formation. Choice C is incorrect because warfarin's primary action is not to dilate coronary arteries. Choice D is incorrect as warfarin is not used to treat rhythm disturbances, but rather to prevent clot formation.

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