Nursing Elites

1. A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?

• A. Keep insulin vials refrigerated at all times.
• B. Rotate the insulin injection sites systematically.
• C. Increase the amount of insulin before unusual exercise.
• D. Monitor the urine acetone level to determine the insulin dosage.

Correct answer: B

Rationale: When a client is stabilized with daily insulin injections, it is crucial to rotate the injection sites systematically. This practice helps prevent the development of lipodystrophy, which can affect insulin absorption and lead to inconsistent glucose control. Additionally, rotating sites minimizes discomfort and tissue damage, ensuring optimal insulin delivery and effectiveness.

2. When providing instructions to a client taking ciprofloxacin (Cipro), which of the following should the nurse include in the teaching plan?

• A. Avoid taking the medication with milk or antacids.
• B. Take the medication with a multivitamin.
• C. Consume extra dairy products while taking this medication.
• D. Take the medication with food if gastrointestinal upset occurs.

Correct answer: A

Rationale: The correct answer is to avoid taking ciprofloxacin (Cipro) with milk or antacids. These can interfere with the medication's absorption. Consuming extra dairy products or taking it with a multivitamin is not recommended for the same reason. If gastrointestinal upset occurs, the medication can be taken with food to help alleviate the symptoms.

3. A healthcare provider is preparing to administer a prescribed dose of digoxin (Lanoxin) to a client. Before administering the medication, the healthcare provider should:

• A. Measure the client's blood pressure.
• B. Check the client's heart rate.
• C. Assess the client's respiratory rate.
• D. Check the client's oxygen saturation level.

Correct answer: B

Rationale: Before administering digoxin (Lanoxin), the healthcare provider should check the client's heart rate. Monitoring the heart rate is crucial because if it is below 60 beats per minute, the medication should be withheld, and the healthcare provider must be informed. While blood pressure, respiratory rate, and oxygen saturation are essential assessments, they are not the primary focus before administering digoxin.

4. A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?

• A. Monitor for renal failure.
• B. Monitor psychosocial status.
• C. Monitor for signs of bleeding.
• D. Have heparin sodium available.

Correct answer: C

Rationale: The priority nursing intervention for a client receiving tissue plasminogen activator (alteplase) for an acute myocardial infarction is to monitor for signs of bleeding. Alteplase is a thrombolytic medication that can lead to hemorrhage as a complication. Therefore, closely monitoring the client for any signs of bleeding is essential to promptly address and manage this potential adverse effect.

5. A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?

• A. I will take my pills every day at the same time.
• B. I will be certain to avoid alcohol consumption.
• C. I have already called my family to pick up a Medic-Alert bracelet.
• D. I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.

Correct answer: D

Rationale: Ecotrin is an aspirin-containing product and should be avoided. Clients should avoid alcohol consumption, take prescribed medication at the same time each day, and use a Medic-Alert bracelet for emergency information.

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