Which symptom reported by a client indicates that the practical nurse (PN) should notify the healthcare provider before giving a scheduled dose of propranolol?

Headache.

Difficulty sleeping.

Palpitations.

Nausea.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Headaches are a common side effect of many medications and do not necessarily indicate a serious problem. However, if the headache is severe or persistent, it should be reported to the healthcare provider.

Choice B rationale

Difficulty sleeping is not typically associated with propranolol. While it can occur, it is not a common side effect and is not usually a cause for concern.

Choice C rationale

Palpitations, or a feeling of a fast, fluttering, or pounding heart, can be a sign of an irregular heartbeat, which can be a serious side effect of propranolol. This is because propranolol is a beta-blocker, a type of drug that can slow heart rate and reduce the force of heart contractions. Therefore, if a patient reports palpitations, the healthcare provider should be notified before the next dose of propranolol is given.

Choice D rationale

Nausea is a common side effect of many medications, including propranolol. However, it is usually mild and temporary. If the nausea is severe, persistent, or accompanied by other symptoms such as vomiting, the healthcare provider should be notified.

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Correct Answer is A

Explanation

Choice A rationale

Sildenafil, commonly known as Viagra, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. One of the side effects of sildenafil is visual changes. These changes can be temporary or long-lasting, and can potentially be a sign of a serious condition known as non-arteritic anterior ischemic optic neuropathy (NAION), which can lead to permanent vision loss. Therefore, it is crucial for the client to report these symptoms to the healthcare provider immediately for further evaluation and management.

Choice B rationale

While eye drops can be used to treat various eye conditions, they are not typically used to address visual changes caused by sildenafil. Therefore, instilling prescribed eye drops would not be the appropriate response in this situation.

Choice C rationale

Wearing dark glasses when outside can help protect the eyes from sun damage, but it would not address the underlying issue of visual changes caused by sildenafil. Therefore, this would not be the appropriate instruction for the practical nurse to give to the client.

Choice D rationale

The Amsler grid tool is used to detect vision problems resulting from damage to the macula (the central part of the retina) or the optic nerve. However, this tool would not be useful in this context as the visual changes are a side effect of sildenafil. Therefore, monitoring for visual changes each morning using an Amsler grid tool would not be the appropriate instruction for the practical nurse to give to the client.

A. Observe the client for development of involuntary movements of the lips and tongue. B. Administer the medication at least 30 minutes before the client’s meals. C. Assess the skin daily for areas of ecchymosis or other signs of bleeding. D. Ensure peak and trough serum levels are collected with the third dose of medication.

Correct Answer is C

Explanation

Choice A rationale

Involuntary movements of the lips and tongue are typically associated with antipsychotic medications, not nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac15. Therefore, observing the client for these symptoms would not be a relevant intervention for a client taking ketorolac15.

Choice B rationale

Administering the medication at least 30 minutes before meals is not a specific requirement for ketorolac15. Therefore, this would not be a necessary intervention for a client taking this medication15.

Choice C rationale

Ketorolac, like other NSAIDs, can increase the risk of bleeding15. This can manifest as areas of ecchymosis (bruising) or other signs of bleeding on the skin15. Therefore, assessing the skin daily for these signs would be an important intervention for a client taking ketorolac15.

Choice D rationale

Peak and trough serum levels are typically monitored for medications with a narrow therapeutic index, such as certain antibiotics15. Ketorolac does not typically require

monitoring of serum levels15. Therefore, ensuring peak and trough serum levels are collected would not be a necessary intervention for a client taking this medication15.

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Which symptom reported by a client indicates that the practical nurse (PN) should notify the healthcare provider before giving a scheduled dose of propranolol?

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is taking sildenafil 50 mg by mouth (PO) as needed (PRN), reports experiencing visual changes to the practical nurse (PN). Which instruction should the PN give to the client?

Correct Answer is A

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The practical nurse (PN) is helping with the care plan for a client who is taking the nonsteroidal anti-inflammatory drug ketorolac for painful back muscle spasms. What intervention should the PN include in the client’s care plan?

Correct Answer is C

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The practical nurse (PN) is managing a patient who is receiving fentanyl subcutaneously (SubQ) every hour for pain control. The patient’s pain level remains at 8 on a 10-point scale. What is the most appropriate action for the PN to take?

A patient with Paget’s disease has been prescribed alendronate. What information should the practical nurse (PN) emphasize to the patient?

A patient with depression who is taking a tricyclic antidepressant (TCA) reports frequent early morning awakening and difficulty going back to sleep. Which information from the patient is important for the Practical Nurse (PN) to obtain to improve the patient’s sleep pattern?

The practical nurse (PN) is preparing to administer a scheduled dose of benztropine to a client with Parkinson’s disease. The client reports having a very dry mouth. Which action should the PN take?

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When a patient is being administered a 20% mannitol intravenous (IV) solution at a rate of 100 g/24 hours (or 70 mg/min), which outcome data should the practical nurse (PN) prioritize in collection?