Nursing Elites

1. A client with a diagnosis of schizophrenia is prescribed olanzapine. The nurse should monitor for which potential side effect?

• A. Weight gain
• B. Insomnia
• C. Dry mouth
• D. Headache

Correct answer: A

Rationale: When a client with schizophrenia is prescribed olanzapine, the nurse should monitor for weight gain as a potential side effect. Olanzapine is known to cause metabolic changes that can lead to weight gain, making it crucial for the nurse to closely monitor the client's weight during treatment. This side effect is significant as it can impact the client's overall health and well-being, so early detection and intervention are essential to manage it effectively.

2. A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?

• A. Take the medication with meals to avoid gastrointestinal upset.
• B. Avoid taking the medication with alcohol.
• C. Increase fluid intake to avoid constipation.
• D. Report any signs of respiratory depression to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.

3. A client with severe depression is prescribed sertraline. Which statement by the client indicates the need for further teaching?

• A. I can stop taking this medication once I feel better.
• B. It may take 1 to 4 weeks to notice improvement in symptoms.
• C. I should avoid alcohol while taking this medication.
• D. I should take this medication in the morning with food.

Correct answer: A

Rationale: The correct answer is A. Clients should not stop taking sertraline abruptly once they feel better without consulting their healthcare provider. It is important to complete the full course of treatment as prescribed to prevent a relapse of symptoms. Stopping the medication suddenly can lead to withdrawal symptoms and may worsen the condition. Choice B is correct because sertraline may take 1 to 4 weeks to show noticeable improvement in symptoms. Choice C is correct as alcohol should be avoided while taking sertraline due to the increased risk of side effects. Choice D is also correct as taking sertraline in the morning with food can help reduce gastrointestinal side effects.

4. A client who takes metformin for diabetes mellitus type 2 is nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?

• A. NPO except for metformin and regular snacks
• B. NPO except for oral antidiabetic agent
• C. Novolin-N insulin subcutaneously twice daily
• D. Regular insulin subcutaneously per sliding scale

Correct answer: D

Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is crucial to manage their glucose levels effectively. The best approach in this situation is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications. Choices A and B are incorrect because metformin is typically held when a client is NPO, and oral antidiabetic agents may not provide sufficient glucose control. Choice C is incorrect as Novolin-N insulin given twice daily may not offer the flexibility needed for glucose management in a surgical setting where the client's intake is restricted.

5. Prior to administration of the initial dose of the GI agent misoprostol, which information should the nurse obtain from the client?

• A. Taking an anti-emetic medication
• B. History of glaucoma
• C. Currently pregnant
• D. Allergy to aspirin

Correct answer: C

Rationale: The correct answer is C. It is crucial for the nurse to obtain information regarding the client's pregnancy status before administering misoprostol, as this medication is contraindicated in pregnancy due to its potential to cause uterine contractions. This can lead to serious complications such as miscarriage or premature birth. Therefore, assessing whether the client is currently pregnant is essential to ensure the safe administration of misoprostol. Choices A, B, and D are not directly related to the administration of misoprostol. While knowing if the client is taking an anti-emetic medication may be relevant to prevent drug interactions, a history of glaucoma and allergy to aspirin are not primary concerns before administering misoprostol.

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