Nursing Elites

1. A client with a diagnosis of generalized anxiety disorder is prescribed paroxetine. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Paroxetine, used for generalized anxiety disorder, can cause drowsiness. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them. Dry mouth, nausea, and headache are potential side effects of other medications but are not commonly associated with paroxetine. Drowsiness is a common side effect for paroxetine and can impact a client's ability to perform tasks that require alertness.

2. A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should include which instruction in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid alcohol while taking this medication.
• C. Take this medication on an empty stomach.
• D. Report any signs of pancreatitis to the healthcare provider.

Correct answer: D

Rationale: The correct instruction to include in the teaching plan for a client prescribed sitagliptin is to report any signs of pancreatitis to the healthcare provider. Sitagliptin is generally taken with meals to reduce gastrointestinal side effects. Therefore, choice A, 'Take this medication with meals,' is incorrect. Sitagliptin does not have specific interactions with alcohol, so there is no need to advise the client to avoid alcohol, making choice B incorrect. Taking sitagliptin on an empty stomach is not recommended, so choice C is also incorrect. Pancreatitis is a rare but serious side effect of sitagliptin, so it is crucial for the client to report any signs or symptoms to their healthcare provider promptly.

3. A client with diabetes mellitus type 2 is prescribed pioglitazone. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Liver toxicity
• C. Kidney stones
• D. Bone fractures

Correct answer: B

Rationale: The correct answer is B, liver toxicity. Pioglitazone is known to cause liver toxicity, so it is essential for the nurse to monitor the client's liver function while on this medication. Monitoring liver function tests can help detect any signs of liver damage early, allowing for timely intervention to prevent serious complications.

4. A client with chronic kidney disease is prescribed ferric citrate. The nurse should monitor for which potential side effect?

• A. Constipation
• B. Diarrhea
• C. Nausea
• D. Hyperphosphatemia

Correct answer: A

Rationale: When a client with chronic kidney disease is prescribed ferric citrate, the nurse should monitor for constipation as a potential side effect. Ferric citrate can lead to constipation due to its effects on the gastrointestinal system, causing a decrease in bowel movements. It is essential for the nurse to assess and manage constipation promptly to prevent complications and ensure the client's comfort and well-being. Monitoring bowel movements, providing adequate hydration, and recommending dietary interventions can help alleviate constipation in clients taking ferric citrate. Diarrhea, nausea, and hyperphosphatemia are not typically associated with the use of ferric citrate in clients with chronic kidney disease.

5. What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?

• A. Obtain a clean-catch urine specimen.
• B. Assess the urine pH for acidity.
• C. Insert an indwelling catheter.
• D. Assess for complaints of dysuria.

Correct answer: A

Rationale: The correct answer is to obtain a clean-catch urine specimen. Before administering ampicillin to a client with a urinary tract infection, it is crucial to collect a urine specimen to determine the causative organism and evaluate the effectiveness of pharmacological therapy. Assessing the urine pH for acidity (choice B) is not the primary intervention needed before administering ampicillin. Inserting an indwelling catheter (choice C) is invasive and not necessary unless indicated for specific reasons. Assessing for complaints of dysuria (choice D) is important but does not take precedence over obtaining a urine specimen for proper diagnosis and treatment.

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