Nursing Elites

1. A client with an exacerbation of asthma is prescribed albuterol. The nurse should assess the client for which common side effect of this medication?

• A. Tremors
• B. Nausea and vomiting
• C. Insomnia
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Tremors. Albuterol, a beta-agonist medication commonly used to treat asthma exacerbations, can lead to tremors as a side effect. Tremors result from the stimulation of beta-2 receptors in muscles, particularly in the hands. Nausea and vomiting (Choice B) are generally not common side effects of albuterol. Insomnia (Choice C) is less likely to occur with albuterol, as it is a stimulant and can cause alertness rather than sleep disturbances. Dry mouth (Choice D) is not a typical side effect associated with albuterol use.

2. A client with diabetes mellitus type 2 is prescribed metformin. What instruction should the nurse include 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 lactic acidosis to the healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals. Taking metformin with meals helps to minimize gastrointestinal side effects, which are common with this medication. Choice B, avoiding alcohol, is a good practice due to the increased risk of lactic acidosis when alcohol is consumed with metformin; however, it is not the priority teaching point in this scenario. Taking metformin on an empty stomach (Choice C) is incorrect because it can increase the risk of gastrointestinal side effects. Reporting signs of lactic acidosis (Choice D) is important, but it is more related to monitoring for adverse effects rather than a primary teaching point for administration.

3. Which action should be taken to assess for analgesic tolerance in a client who is unable to communicate?

• A. Review the client's laboratory values for changes in peak and trough levels of the analgesic
• B. Prolong the interval between analgesic medication doses and monitor the client's vital signs
• C. Observe the client for the presence of pain behaviors before the next analgesic dose is due
• D. Ask family members to report behaviors suggesting that the client's pain has returned

Correct answer: C

Rationale: In clients who are unable to communicate, observing for pain behaviors is crucial in assessing analgesic tolerance. Changes in pain behaviors can indicate if the current analgesic regimen is effective or if tolerance has developed. Therefore, closely observing the client for pain behaviors before the next analgesic dose helps healthcare providers evaluate the client's response to pain management. Reviewing laboratory values may not directly reflect analgesic tolerance. Prolonging the interval between doses and monitoring vital signs may not provide direct information on analgesic tolerance. Relying solely on family members to report pain behaviors may not be as accurate or immediate as observing the client directly.

4. A 67-year-old client is discharged from the hospital with a prescription for digoxin 0.25 mg daily. Which instruction by the practical nurse (PN) is correct?

• A. Take the medication in the morning before getting out of bed.
• B. Do not take the medication if the heartbeat is irregular or slow.
• C. Expect some vision changes due to the medication.
• D. Increase intake of foods rich in potassium.

Correct answer: B

Rationale: The correct instruction for a client taking digoxin is not to take the medication if the heartbeat is irregular or slow. Digoxin can affect the heart rhythm, so it is crucial to monitor the pulse rate. In case of irregular or slow heartbeats, the medication should be withheld, and the healthcare provider should be consulted. This step is necessary to prevent potential complications associated with digoxin therapy. Choices A, C, and D are incorrect. Taking digoxin in the morning before getting out of bed is not a specific requirement. Vision changes are not a common side effect of digoxin. While digoxin can affect potassium levels, it is not advised to increase potassium intake without healthcare provider guidance.

5. A client with chronic kidney disease is prescribed sevelamer. The nurse should monitor for which potential side effect?

• A. Hypercalcemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: B

Rationale: When a client with chronic kidney disease is prescribed sevelamer, the nurse should monitor for hypocalcemia. Sevelamer works by binding dietary phosphorus in the gastrointestinal tract, which can lead to decreased calcium absorption and potentially cause hypocalcemia.

Similar Questions