Nursing Elites

1. During an assessment, a male client who has recently started taking Haloperidol is displaying certain symptoms. Which of the following findings should the nurse prioritize in reporting to the provider?

• A. Shuffling gait
• B. Neck spasms
• C. Drowsiness
• D. Impotence

Correct answer: B

Rationale: Neck spasms are indicative of acute dystonia, a serious side effect of Haloperidol that requires urgent intervention. Immediate reporting to the provider is crucial to address this potentially harmful condition and ensure the client's safety. Shuffling gait, drowsiness, and impotence are important to monitor but do not pose the same level of immediate risk as acute dystonia. Acute dystonia can lead to serious complications if not promptly treated, making it the priority in this scenario.

2. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.

3. A client informs the nurse that she has difficulty swallowing tablets and struggles with liquid or chewable medications due to taste. What medication should the nurse request a prescription for when preparing to administer Penicillin V to treat the client's streptococcal infection?

• A. Fosfomycin
• B. Amoxicillin
• C. Nafcillin
• D. Cefaclor

Correct answer: C

Rationale: Nafcillin is an appropriate alternative within the penicillin class for clients who have difficulty swallowing tablets or struggle with liquid or chewable medications. It is available for intramuscular (IM) or intravenous (IV) administration, offering options beyond oral formulations. Fosfomycin, Amoxicillin, and Cefaclor are not suitable alternatives for Penicillin V in this scenario as they belong to different classes of antibiotics and may not be as effective in treating streptococcal infections.

4. A client has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?

• A. You should have a high-carbohydrate snack between meals and at bedtime.
• B. You are likely to develop hand tremors if you take this medication for a long period of time.
• C. You may experience temporary numbness of your mouth after each dose.
• D. You should have your white blood cell count monitored every week.

Correct answer: D

Rationale: Clozapine has a risk for fatal agranulocytosis, making weekly monitoring of the client's white blood cell (WBC) count essential to detect any potential issues early. This monitoring helps in managing the risk and ensuring the client's safety while on clozapine.

5. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a different site each day.
• B. Remove the patch at bedtime each day.
• C. Apply the patch over an area with little or no hair.
• D. Keep the patch on for 24 hours at a time.

Correct answer: B

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each day, usually at bedtime, to prevent tolerance. This practice allows for a nitrate-free interval, reducing the risk of developing tolerance to the medication. Applying the patch to a different site each day (choice A) is not necessary as long as the skin is clean and rotated to avoid skin irritation. Applying the patch over an area with little or no hair (choice C) does not impact the effectiveness of the medication. Keeping the patch on for 24 hours at a time (choice D) can lead to tolerance, which is why the patch should be removed daily.

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