Nursing Elites

1. A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:

• A. Drink at least 2 L of fluid per day.
• B. Take the daily dose at bedtime.
• C. Avoid changing brands of the medication without health care provider (HCP) approval.
• D. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP.

Correct answer: B

Rationale: The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.

2. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:

• A. Should always be taken with food or antacids
• B. Should be double-dosed if one dose is forgotten
• C. Causes orange discoloration of sweat, tears, urine, and feces
• D. May not be discontinued independently if symptoms are gone in 3 months

Correct answer: C

Rationale: Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.

3. 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.

4. A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?

• A. The development of complaints of insomnia
• B. The development of audible expiratory wheezes
• C. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
• D. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication

Correct answer: B

Rationale: The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.

5. A client is being educated about the use of sertraline (Zoloft) for depression. Which statement by the client indicates a need for further teaching?

• A. I should take the medication with a high-protein meal.
• B. I may experience dizziness when getting up quickly.
• C. I might notice a decrease in my sex drive.
• D. I should report any thoughts of self-harm to my healthcare provider.

Correct answer: A

Rationale: The statement 'I should take the medication with a high-protein meal' indicates a need for further teaching as sertraline (Zoloft) should not be taken with a high-protein meal due to potential interference with medication absorption. Choices B, C, and D are correct statements associated with the use of sertraline for depression. It is common to experience dizziness when quickly getting up, notice a decrease in sex drive, and important to report any thoughts of self-harm to the healthcare provider while on this medication.

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