Nursing Elites

1. A healthcare provider is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The provider should recognize which of the following conditions is a contraindication for taking propranolol?

• A. Asthma
• B. Glaucoma
• C. Hypertension
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Asthma. Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, making it contraindicated in clients with asthma. Using propranolol in asthma can exacerbate bronchoconstriction and potentially lead to respiratory distress or exacerbation of asthma symptoms. Choices B, C, and D are incorrect. Glaucoma, hypertension, and tachycardia are not contraindications for taking propranolol. In fact, propranolol is commonly used to treat hypertension and tachycardia.

2. While teaching a client with a new prescription for Warfarin, which of the following statements by the client indicates a need for further teaching?

• A. I will avoid eating large amounts of green leafy vegetables.
• B. I will take my medication at the same time every day.
• C. I will increase my intake of foods high in potassium.
• D. I will report any signs of bleeding to my provider.

Correct answer: C

Rationale: The correct answer is C because Warfarin interacts with vitamin K, found in green leafy vegetables, not potassium. The client should avoid consuming large amounts of foods high in vitamin K to maintain the effectiveness of Warfarin therapy. Increasing potassium intake is not a concern related to Warfarin therapy, so this statement indicates a need for further teaching. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding large amounts of green leafy vegetables helps prevent fluctuations in vitamin K levels, taking medication consistently maintains therapeutic levels, and reporting any signs of bleeding is essential for monitoring and managing potential side effects of Warfarin.

3. A client with peptic ulcer disease is prescribed sucralfate. Which of the following instructions should the nurse include?

• A. Take sucralfate with meals.
• B. Take sucralfate 1 hr before meals.
• C. Take sucralfate with antacids.
• D. Take sucralfate 2 hours after meals.

Correct answer: B

Rationale: The correct instruction for taking sucralfate is 1 hour before meals. This timing allows sucralfate to effectively coat the stomach lining and provide a protective barrier against gastric acid, helping to prevent ulcers.

4. A healthcare professional is caring for four clients who have Peptic Ulcer Disease. The healthcare professional should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor and potentially lead to harm to the fetus. Therefore, it should not be used in pregnant clients due to its uterotonic effects. For clients with osteoarthritis, kidney stone, or urinary tract infection, Misoprostol is not contraindicated specifically for these conditions.

5. A healthcare provider is caring for a client who is prescribed Digoxin. Which of the following laboratory values should the provider monitor to assess for potential toxicity?

• A. Sodium
• B. Potassium
• C. Magnesium
• D. Calcium

Correct answer: B

Rationale: The correct answer is to monitor the client's potassium levels. Hypokalemia can increase the risk of Digoxin toxicity. Potassium levels should be closely monitored to prevent adverse effects. Monitoring sodium levels is not directly related to Digoxin toxicity. While magnesium and calcium are important electrolytes, potassium levels are more critical for Digoxin toxicity assessment.

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