Nursing Elites

1. The healthcare professional is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the healthcare professional to question administering this drug?

• A. Respirations 12 breaths per minute
• B. Pulse 52 beats per minute
• C. Blood pressure 134/72
• D. Oxygen saturation 95%

Correct answer: B

Rationale: Atenolol is a beta-blocker medication that can lower heart rate. A pulse of 52 beats per minute is relatively low and administering atenolol could further decrease the heart rate, potentially leading to bradycardia. Monitoring the pulse rate and holding the medication if the pulse is below the prescribed parameters is crucial to prevent adverse effects such as bradycardia and hypotension.

2. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

3. A client has a new prescription for Beclomethasone. Which of the following instructions should the nurse include in the teaching?

• A. Take the medication with meals.
• B. Increase your intake of calcium-rich foods.
• C. Rinse your mouth after each use.
• D. Limit fluid intake while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'Rinse your mouth after each use.' Beclomethasone can cause oral candidiasis (thrush) as an adverse effect. Rinsing the mouth after each use helps reduce the risk of developing thrush by removing any residue of the medication from the mouth, which can promote fungal growth. Choices A, B, and D are incorrect. Taking the medication with meals, increasing calcium-rich foods intake, or limiting fluid intake are not specific instructions related to minimizing the side effect of oral candidiasis associated with Beclomethasone.

4. When reviewing a client's health record, a nurse notes a new prescription for Lisinopril 10 mg PO once daily. The nurse should identify this as which type of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates medications to be administered on a regular schedule without a termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily falls under a routine prescription, meaning the nurse will administer this medication daily until the provider discontinues it. Choices A, B, and D are incorrect: A 'single' prescription is for a one-time dose, 'stat' prescriptions are for immediate administration, and 'standing' prescriptions are pre-authorized for administration as needed within specified parameters.

5. A client with chronic kidney disease has a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

• A. Iron
• B. Protein
• C. Potassium
• D. Sodium

Correct answer: A

Rationale: Patients with chronic kidney disease are often prescribed epoetin alfa to treat anemia. Epoetin alfa stimulates red blood cell production, increasing the body's demand for iron to support this process. Therefore, clients taking epoetin alfa should be advised to increase their dietary intake of iron-rich foods to meet the increased demand and prevent iron deficiency anemia. Choices B, C, and D are incorrect because while protein is essential for overall health, potassium and sodium intake may need to be restricted in clients with chronic kidney disease to manage electrolyte balance and blood pressure.

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