Nursing Elites

1. A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?

• A. Remove the prior dose before applying a new dose.
• B. Rub the ointment directly into the skin until it is no longer visible.
• C. Cover the applied ointment with a clean gauze pad.
• D. Apply the ointment to the same skin area each time.

Correct answer: A

Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.

2. 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.

3. A client is starting a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Weigh yourself daily.
• B. Limit sodium intake.
• C. Increase potassium intake.
• D. Avoid potassium-rich foods.

Correct answer: A

Rationale: The correct instruction to include when starting furosemide is to weigh yourself daily. Daily weighing helps monitor for fluid loss or retention, which is crucial when taking a diuretic like furosemide. Choices B, C, and D are incorrect because although monitoring sodium intake and potassium levels are important when taking furosemide, the most immediate and direct way to assess the medication's effectiveness and the body's response is through daily weight monitoring.

4. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This situation can result in increased drug levels in the body, causing drowsiness and other side effects. Adjusting the dosage of the hypnotic medication may be necessary to prevent such adverse effects in older adult clients. Choice A, reduced cardiac function, is not directly related to the metabolism of the medication and is unlikely to cause drowsiness. Choice B, first-pass effect, refers to the initial metabolism of a drug in the liver before it enters circulation, but it is not the cause of drowsiness in this scenario. Choice D, increased gastric motility, does not play a significant role in the metabolism of the medication and is not a likely cause of the client's drowsiness.

5. A client is receiving treatment with etoposide. Which of the following findings should the nurse monitor?

• A. Hypotension
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypertension

Correct answer: A

Rationale: Etoposide, a chemotherapeutic agent, commonly causes hypotension as an adverse effect. It is crucial for the nurse to monitor the client for signs of hypotension, such as dizziness, lightheadedness, or a drop in blood pressure, to promptly intervene and prevent complications.

Similar Questions