Nursing Elites

1. A healthcare professional is reviewing the medical record of a client with a new prescription for Epoetin Alfa. Which of the following findings should the professional report to the provider?

• A. The client has a history of hypertension.
• B. The client has a hemoglobin level of 10 g/dL.
• C. The client has a history of chronic kidney disease.
• D. The client has a blood pressure of 140/90 mm Hg.

Correct answer: C

Rationale: The correct answer is C. Chronic kidney disease is a contraindication for the use of Epoetin Alfa because it can worsen hypertension, increase the risk of cardiovascular events, and lead to adverse outcomes. Epoetin Alfa is used to treat anemia by stimulating red blood cell production, but in the presence of chronic kidney disease, it can exacerbate hypertension and contribute to cardiovascular complications. Choices A, B, and D are not directly related to the contraindication of Epoetin Alfa in the presence of chronic kidney disease.

2. A client has a new prescription for Atorvastatin. Which of the following instructions should be included?

• A. Take this medication with food.
• B. Avoid drinking grapefruit juice.
• C. Take this medication in the morning.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to avoid drinking grapefruit juice when taking Atorvastatin. Grapefruit juice can interfere with the metabolism of Atorvastatin, leading to increased blood levels of the medication, which can result in a higher risk of adverse effects, such as muscle pain and liver damage. It is important for the client to follow this instruction to ensure the safe and effective use of Atorvastatin. Choices A, C, and D are incorrect. While taking Atorvastatin with food may be recommended for some individuals to reduce stomach upset, it is not a crucial instruction. The timing of Atorvastatin administration can vary depending on individual needs and is not universally fixed to the morning. Increasing potassium-rich foods is not directly related to Atorvastatin use and is not a standard precautionary measure associated with this medication.

3. While caring for a client taking Propylthiouracil, for which of the following adverse effects should the nurse monitor?

• A. Bradycardia
• B. Insomnia
• C. Heat intolerance
• D. Weight loss

Correct answer: A

Rationale: When a client is taking Propylthiouracil, the nurse should monitor for bradycardia as it is an adverse effect of this medication. Propylthiouracil can lead to a decrease in heart rate, which is known as bradycardia. Monitoring for this adverse effect is crucial to ensure the client's safety and well-being while on this medication. The other options, such as insomnia, heat intolerance, and weight loss, are not commonly associated adverse effects of Propylthiouracil. Therefore, they are incorrect choices for monitoring while the client is on this medication.

4. A client has been prescribed a new oral hypoglycemic agent for diabetes. Which of the following statements by the client indicates a need for further teaching?

• A. I will take this medication with my evening snack.
• B. I will monitor my blood sugar levels before each meal.
• C. I will take this medication as soon as I wake up.
• D. I will follow my exercise plan as usual.

Correct answer: A

Rationale: Taking an oral hypoglycemic agent with an evening snack may lead to hypoglycemia during the night. It is important to follow the prescribed timing for medication administration to maintain blood sugar levels within the target range. The medication is usually taken before meals to help control postprandial blood glucose levels effectively. Choice B is correct as monitoring blood sugar levels before each meal is a good practice. Choice C is incorrect as taking the medication upon waking up may align with certain oral hypoglycemic agents' dosing schedules. Choice D is also correct as regular exercise is an important part of managing diabetes.

5. Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?

• A. Antiplatelets
• B. Beta-adrenergic blockers
• C. ACE inhibitors
• D. Calcium channel blockers

Correct answer: B

Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.

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