Nursing Elites

1. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.

2. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: The correct answer is C, Regular insulin. Regular insulin, also known as short-acting insulin, typically exhibits a peak effect around 1 to 5 hours following administration. This rapid onset and peak effect make it suitable for managing postprandial glucose levels. Insulin glargine is a long-acting insulin with no pronounced peak effect, making it unsuitable for rapid glucose control within 1 to 5 hours. NPH insulin has an intermediate duration of action and a different peak time frame. Insulin lispro is a rapid-acting insulin that peaks within 30 minutes to 2.5 hours after administration, not within the 1 to 5-hour range.

3. When does regular insulin typically peak?

• A. 30 minutes to 2 ½ hours
• B. 1 to 3 hours
• C. 6 to 14 hours
• D. 1 to 5 hours

Correct answer: D

Rationale: Regular insulin usually peaks around 1 to 5 hours after administration. This peak time frame is important to consider when managing blood glucose levels and timing meals to coincide with insulin activity. Choice A, '30 minutes to 2 ½ hours,' is incorrect because regular insulin typically peaks later. Choice B, '1 to 3 hours,' is not the most accurate as the peak for regular insulin can extend beyond 3 hours. Choice C, '6 to 14 hours,' is incorrect as this timeframe is more indicative of long-acting insulins, not regular insulin.

4. A client has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide?

• A. Take the medication on an empty stomach to decrease gastrointestinal irritation.
• B. Take the medication with orange juice to enhance absorption.
• C. Take the medication with milk.
• D. Rinse the mouth before taking the iron.

Correct answer: B

Rationale: Taking ferrous sulfate with orange juice can help increase the absorption of iron. Orange juice contains vitamin C, which aids in the absorption of iron from the medication. This combination can enhance the effectiveness of the iron supplement for a client with anemia. Option A is incorrect because taking iron on an empty stomach can cause gastrointestinal upset. Option C is incorrect because calcium in milk can inhibit iron absorption. Option D is irrelevant to enhancing iron absorption.

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

• A. Take this medication before meals.
• B. Take this medication with food.
• C. Take this medication at bedtime.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication before meals.' Omeprazole is a proton pump inhibitor that is most effective in reducing stomach acid production when taken before meals. This timing helps the medication work optimally by inhibiting acid secretion that occurs in response to food intake. Choice B ('Take this medication with food') is incorrect because Omeprazole should be taken before meals. Choice C ('Take this medication at bedtime') is incorrect as the optimal timing is before meals, not at bedtime. Choice D ('Take this medication with antacids') is incorrect because Omeprazole should not be taken with antacids as they can interfere with its absorption.

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