Nursing Elites

1. The healthcare provider is discharging a patient with a new prescription for ranitidine (Zantac). Which information would be important to include in the discharge teaching?

• A. Thrombolytic thrombocytopenic purpura (TTP) may occur
• B. Aspirin should not be taken with this medication
• C. The patient may experience iron deficiency anemia
• D. The patient may experience restlessness

Correct answer: D

Rationale: The correct answer is D. It is important to include information that ranitidine may cause restlessness as a side effect in some patients. Educating the patient about possible side effects helps in early recognition and management, improving medication adherence and patient safety. Choices A, B, and C are incorrect because they do not pertain to common side effects or specific considerations related to ranitidine use.

2. A client is prescribed clonidine 0.1 mg/24 hours via a transdermal patch. Which client outcome would indicate that the medication is effective?

• A. No complaints of recent episodes of angina
• B. Change in peripheral edema from +3 to +1
• C. No complaints of new onset of nausea or vomiting
• D. Blood pressure changes from 180/120 to 140/70 mm Hg

Correct answer: D

Rationale: Clonidine is an antihypertensive agent that works centrally to reduce blood pressure. A significant decrease in blood pressure, such as changing from 180/120 to 140/70 mm Hg, indicates that the medication is effectively managing hypertension. Monitoring blood pressure levels is crucial in assessing the response to clonidine therapy. Choices A, B, and C are incorrect as they do not directly relate to the therapeutic effect of clonidine in managing hypertension, which is the primary goal of the medication in this scenario.

3. In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?

• A. Withdraw ten units of regular insulin from a vial
• B. Withhold the dose until regular insulin is available
• C. Obtain a new vial of regular insulin and withhold
• D. Pull up 30 units from a vial but only administer 10 units

Correct answer: B

Rationale: In insulin administration, regular insulin is typically administered before isophane insulin to manage blood glucose effectively. If regular insulin is not available, it is best to withhold the dose until it can be administered as prescribed. Choice A is incorrect as it suggests withdrawing from a specific vial without specifying regular insulin. Choice C is incorrect as obtaining a new vial of regular insulin may not be necessary if it becomes available shortly. Choice D is incorrect as administering 10 units from a mixture of regular and isophane insulin is not the correct approach.

4. A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?

• A. Wort can decrease plasma concentration of Cyclospora
• B. Wort can decrease plasma concentration of Tacrolimus
• C. Wort can decrease plasma concentration of Cyclosporine
• D. Wort can decrease plasma concentration of Mycophenolate

Correct answer: C

Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.

5. A healthcare professional prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's heart rate is 48 beats/min, respirations are 16 breaths/min, and blood pressure is 150/90 mmHg.

• A. Administer the dose and monitor the client's blood pressure regularly
• B. Apply a telemetry monitor before administering the dose
• C. Assess for orthostatic hypotension before administering the dose
• D. Withhold the scheduled dose and notify the healthcare provider

Correct answer: D

Rationale: The client's low heart rate of 48 beats/min indicates bradycardia, a potential side effect of labetalol. Administering the dose in this case could further lower the heart rate, potentially causing adverse effects. Therefore, it is crucial to withhold the scheduled dose and notify the healthcare provider for further assessment and guidance. Choice A is incorrect because administering the dose without addressing the bradycardia can exacerbate the condition. Choice B is not relevant in this situation as telemetry monitoring is not the priority. Choice C is also not the priority in this case, as the focus should be on the client's bradycardia and the potential adverse effects of administering labetalol.

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