Nursing Elites

1. When educating a client starting a new prescription for metoprolol, which instruction should the nurse include?

• A. Check your pulse before taking the medication.
• B. Take the medication with food to increase absorption.
• C. Avoid sudden changes in position.
• D. Monitor your blood pressure regularly.

Correct answer: C

Rationale: The correct instruction for a client starting metoprolol is to avoid sudden changes in position. Metoprolol can cause dizziness due to its blood pressure-lowering effects, increasing the risk of falls and injury. Instructing the client to change positions slowly helps prevent orthostatic hypotension and related adverse events. Checking the pulse before taking the medication (Choice A) is not typically necessary for metoprolol. Taking the medication with food (Choice B) is not required for absorption and can be taken with or without food. Monitoring blood pressure regularly (Choice D) is essential for clients taking metoprolol, but avoiding sudden changes in position is more critical to prevent dizziness and falls.

2. A client is receiving imatinib. Which of the following adverse effects should the nurse monitor?

• A. Edema
• B. Constipation
• C. Dry mouth
• D. Urinary retention

Correct answer: A

Rationale: Corrected Rationale: Imatinib is known to cause edema as an adverse effect. The nurse should closely monitor the client for signs of fluid retention, such as swelling of the extremities or weight gain. Edema can indicate potential complications and requires prompt intervention to prevent further issues. Choices B, C, and D are incorrect because they are not typically associated with imatinib use. Constipation, dry mouth, and urinary retention are not commonly reported adverse effects of imatinib therapy.

3. What is the pharmacological action of metformin?

• A. Blocks stimulation of beta1 and beta2.
• B. Blocks vasoconstriction and aldosterone.
• C. Acts at many levels in the CNS to produce an anxiolytic effect.
• D. Decreases hepatic glucose production.

Correct answer: D

Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.

4. A healthcare provider is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare provider should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders that can be caused by certain medications affecting the central nervous system, such as typical antipsychotic medications. These effects can lead to symptoms like tremors, muscle rigidity, and involuntary movements, which are all related to disruptions in the central nervous system. Choices A, B, and D are incorrect because extrapyramidal effects are specifically associated with the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

5. 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.

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