Nursing Elites

1. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.

2. A client has Diabetes Mellitus, Pulmonary Tuberculosis, and a new prescription for Isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH?

• A. Ascorbic acid
• B. Pyridoxine
• C. Folic acid
• D. Cyanocobalamin

Correct answer: B

Rationale: Pyridoxine is administered with Isoniazid to prevent peripheral neuropathy, a common adverse effect of the drug. It is essential to provide this supplement to the client to minimize the risk of developing this adverse effect. Ascorbic acid (Vitamin C) is not typically given to prevent INH adverse effects. Folic acid and Cyanocobalamin are not commonly administered with INH for this purpose.

3. A preschooler weighing 44 lb is to receive Amoxicillin 20 mg/kg/day PO divided equally every 12 hr. The available amoxicillin suspension is 250 mg/5 mL. How many mL should the nurse administer per dose?

• A. 4 mL
• B. 5 mL
• C. 6 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage per administration: First, convert the weight to kg (44 lb / 2.2 lb/kg = 20 kg). Then, calculate the required dosage per dose: (20 mg/kg/day x 20 kg) / 2 (for every 12 hr dosing) = 200 mg per dose. To determine the mL per dose, divide the required dosage by the concentration of the amoxicillin suspension: (200 mg / 250 mg) x 5 mL = 4 mL per dose. Therefore, the correct answer is 4 mL. Choice B (5 mL) is incorrect because the correct calculation yields 4 mL. Choices C (6 mL) and D (3 mL) are also incorrect as they do not align with the accurate calculation based on the provided information.

4. A client is being discharged with a new prescription for Atenolol. Which of the following instructions should the nurse include?

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

Correct answer: B

Rationale: The correct answer is B: 'Monitor your heart rate regularly.' Atenolol is a beta-blocker that can cause bradycardia (slow heart rate). Monitoring the heart rate regularly is crucial to promptly detect any significant decreases. This allows for timely intervention and adjustment of the medication regimen if needed, helping to prevent adverse effects associated with bradycardia. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning does not address the need for heart rate monitoring. Avoiding foods high in potassium is more relevant for medications like ACE inhibitors or potassium-sparing diuretics. Increasing fluid intake is not directly related to the use of Atenolol.

5. A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?

• A. Reflex tachycardia
• B. Dizziness
• C. Hyponatremia
• D. Hypotension

Correct answer: C

Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.

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