Nursing Elites

1. A client with asthma is receiving long-term glucocorticoid therapy. The nurse includes a risk for impaired skin integrity on the client's problem list. What is the rationale for including this problem?

• A. Abnormal fat deposits impair circulation
• B. Frequent diarrhea can lead to skin issues
• C. Thinned skin bruises easily
• D. Decreased serum glucose prolongs healing time

Correct answer: C

Rationale: The correct answer is C. Glucocorticoids can cause skin thinning, which increases the likelihood of bruising. Thinning of the skin due to glucocorticoid therapy makes it more fragile and prone to injury, such as bruising, even with minimal trauma. Choices A, B, and D are incorrect because abnormal fat deposits impairing circulation, frequent diarrhea causing skin issues, and decreased serum glucose prolonging healing time are not direct effects of glucocorticoid therapy on skin integrity.

2. Twenty-four hours after starting to take oral penicillin for strep throat, a client calls the nurse to report the onset of a rash on the chest. What action should the nurse implement?

• A. Instruct the client to discontinue the penicillin immediately
• B. Instruct the client regarding the use of topical analgesic cream PRN
• C. Question the client about any other related symptoms
• D. Reinforce the need to take all doses of the penicillin

Correct answer: A

Rationale: In this scenario, the client has developed a rash after starting oral penicillin, which can indicate an allergic reaction. It is crucial for the nurse to instruct the client to discontinue the penicillin immediately. Continuing the medication can potentially lead to severe allergic reactions. Instructing about topical analgesic cream or questioning about other related symptoms may delay appropriate action in case of a severe allergic reaction. Reinforcing the need to complete all doses is not appropriate when an allergic reaction is suspected, as safety takes precedence over completing the antibiotic course.

3. How should the healthcare provider schedule the administering of propylthiouracil (PTU)?

• A. Offer both drugs together with a meal
• B. Give parental dose once every 24 hours
• C. Schedule both medications at bedtime
• D. Administer iodine one hour before PTU

Correct answer: D

Rationale: Administering iodine one hour before PTU is crucial to ensure proper absorption and effectiveness of PTU. This timing helps optimize the therapeutic benefits of PTU by allowing it to be absorbed efficiently without interference from iodine, ultimately leading to better treatment outcomes for the patient. Choices A, B, and C are incorrect because offering both drugs together with a meal, giving parental dose once every 24 hours, and scheduling both medications at bedtime do not address the specific timing requirement of administering iodine before PTU for optimal absorption.

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

• A. Genital infections
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Genital infections. Empagliflozin, a medication commonly used to treat type 2 diabetes, is associated with an increased risk of genital infections. This is due to its mechanism of action, which involves promoting the excretion of glucose through urine, creating a more favorable environment for fungal or bacterial growth in the genital area. Choices B and C, hypoglycemia and hyperglycemia, are less likely adverse effects of empagliflozin. Empagliflozin actually carries a low risk of causing hypoglycemia since it works independently of insulin. Nausea (Choice D) is not a commonly reported adverse effect of empagliflozin, making it an incorrect choice in this scenario.

5. A client is prescribed an antacid for the treatment of peptic ulcer disease. What is the action of this medication that is effective in treating the client's ulcer?

• A. Decrease in the production of gastric secretions
• B. Production of an adherent barrier over the ulcer
• C. Maintenance of a gastric pH of 3.5 or above
• D. Decrease in the gastric motor activity

Correct answer: C

Rationale: The correct answer is C. Antacids work by neutralizing gastric acids and maintaining a gastric pH of 3.5 or above. This pH level is crucial to prevent the activation of pepsinogen, a precursor to pepsin, which can further damage the ulcer. Choice A is incorrect because antacids do not directly decrease the production of gastric secretions; they neutralize existing acid. Choice B is incorrect as antacids do not form a physical barrier over the ulcer but rather neutralize the acid around it. Choice D is also incorrect as antacids do not affect gastric motor activity but focus on reducing acidity in the stomach.

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