Nursing Elites

1. A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Increase your fluid intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client starting Metoprolol is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, leading to dizziness and falls if the client changes positions quickly. By advising the client to make position changes slowly, the nurse helps prevent these adverse effects and promotes safety.

2. A client with chronic kidney disease has a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

• A. Iron
• B. Protein
• C. Potassium
• D. Sodium

Correct answer: A

Rationale: Patients with chronic kidney disease are often prescribed epoetin alfa to treat anemia. Epoetin alfa stimulates red blood cell production, increasing the body's demand for iron to support this process. Therefore, clients taking epoetin alfa should be advised to increase their dietary intake of iron-rich foods to meet the increased demand and prevent iron deficiency anemia. Choices B, C, and D are incorrect because while protein is essential for overall health, potassium and sodium intake may need to be restricted in clients with chronic kidney disease to manage electrolyte balance and blood pressure.

3. A client is starting therapy with cisplatin. The healthcare provider should instruct the client to report which of the following adverse effects?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is tinnitus. Cisplatin can cause ototoxicity, which may manifest as tinnitus. Tinnitus should be reported promptly to the healthcare provider to prevent further hearing damage.

4. What is the therapeutic use of metformin?

• A. Lower blood pressure
• B. Diminish seizure activity
• C. The maintenance of a person's blood glucose levels
• D. Increase heart rate and decrease gastrointestinal secretions

Correct answer: C

Rationale: Metformin is commonly prescribed to manage and control blood glucose levels in individuals with diabetes. It helps in reducing the amount of glucose produced by the liver and improves the body's response to insulin, thereby aiding in the regulation of blood sugar levels. It is not used to lower blood pressure, diminish seizure activity, increase heart rate, or decrease gastrointestinal secretions.

5. A client with Graves' disease is being educated by a nurse about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heartbeat.
• D. Propranolol promotes a decrease of thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that is commonly used in Graves' disease to decrease symptoms such as tremors and fast heart rate. Choice A is incorrect because Propranolol does not increase blood flow to the thyroid gland. Choice B is incorrect as Propranolol is not used to prevent excess glucose in the blood. Choice D is also incorrect as Propranolol does not directly decrease thyroid hormone levels in the body.

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