Nursing Elites

1. The healthcare provider is caring for a client with hypertension who is receiving a beta blocker. The provider should monitor for which potential side effect?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperglycemia

Correct answer: B

Rationale: Corrected Rationale: Beta blockers are medications that can cause bradycardia by slowing down the heart rate. It is essential to monitor for this side effect in clients receiving beta blockers, as it can lead to serious complications such as decreased cardiac output and hypotension. Choices A, C, and D are incorrect because beta blockers are not expected to cause tachycardia (fast heart rate), hypertension (high blood pressure), or hyperglycemia (high blood sugar levels).

2. A hypertensive client who has been taking metoprolol (Lopressor) has been prescribed to decrease the dose of the medication. The client asks the nurse why this must be done over a period of 1 to 2 weeks. In formulating a response, the nurse incorporates the understanding that abrupt withdrawal could affect the client in which way?

• A. Result in hypoglycemia
• B. Give the client insomnia
• C. Precipitate rebound hypertension
• D. Cause enhanced side effects of other prescribed medications

Correct answer: C

Rationale: Abruptly stopping metoprolol can lead to rebound hypertension, causing a sudden increase in blood pressure due to the sudden withdrawal of the medication. Gradually tapering the dose helps the body adjust and reduces the risk of this adverse effect. Choices A, B, and D are incorrect. Stopping metoprolol suddenly is not known to result in hypoglycemia, insomnia, or enhanced side effects of other medications.

3. The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage does the nurse instruct the client to select from the menu?

• A. Tea
• B. Cola
• C. Coffee
• D. Lemonade

Correct answer: D

Rationale: Lemonade is the correct choice as it is caffeine-free, unlike tea, cola, and coffee, which contain caffeine that can potentially affect the client's heart rhythm. Caffeine can increase heart rate and blood pressure, which may not be advisable for a client with a recent MI. Tea, cola, and coffee should be avoided due to their caffeine content, which can have stimulant effects on the heart and may not be beneficial for a client recovering from a myocardial infarction.

4. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which instruction should the nurse give to the client regarding lifestyle changes?

• A. Avoid prolonged sitting or standing.
• B. Use an electric razor to prevent cuts.
• C. Take your medication with a full glass of water.
• D. Eat a diet low in protein.

Correct answer: B

Rationale: The correct answer is B. Using an electric razor is advised to prevent cuts, which is crucial for individuals taking warfarin due to the increased risk of bleeding associated with this medication. Lifestyle changes related to warfarin therapy focus on minimizing the risk of bleeding, and using safety measures such as an electric razor is a practical recommendation to reduce the likelihood of injury. Choices A, C, and D are incorrect. Avoiding prolonged sitting or standing is more related to preventing blood clots than to the bleeding risk of warfarin. Taking warfarin with a full glass of water is not a specific lifestyle change associated with its use. Eating a diet low in protein is not a typical recommendation for individuals on warfarin therapy.

5. A client is receiving morphine for pain. Which of the following assessments is the priority?

• A. Urine output
• B. Pupil reaction
• C. Respiratory rate
• D. Bowel sounds

Correct answer: C

Rationale: The correct answer is C: Respiratory rate. Monitoring the respiratory rate is the priority assessment for a client receiving morphine due to the risk of respiratory depression. Morphine is a potent opioid that can cause respiratory depression, which is a serious adverse effect that can be life-threatening. Assessing the client's respiratory rate is crucial to detect any signs of respiratory depression early and intervene promptly. Assessing urine output is important but not as critical as monitoring for respiratory depression with morphine. Pupil reaction and bowel sounds are also important assessments but do not take precedence over monitoring the respiratory rate when a client is on morphine.

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