Nursing Elites

1. A client with diabetes mellitus is prescribed insulin glargine. What information should the practical nurse (PN) provide to the client about this medication?

• A. Administer the insulin at mealtimes.
• B. Do not mix this insulin with other insulins.
• C. Shake the vial well before use.
• D. Store the insulin in the freezer.

Correct answer: B

Rationale: Insulin glargine is a long-acting insulin that should not be mixed with other insulins in the same syringe. Mixing it with other insulins can alter its pharmacokinetics and effectiveness. Insulin glargine is usually administered at the same time each day, often at bedtime, to provide a consistent basal level of insulin over 24 hours.

2. A client with rheumatoid arthritis is prescribed methotrexate. The nurse should monitor for which common side effect of this medication?

• A. Liver toxicity
• B. Skin rash
• C. Hair loss
• D. Abdominal pain

Correct answer: A

Rationale: The correct answer is A: Liver toxicity. Methotrexate is known to cause liver toxicity, making regular monitoring of liver function essential. Monitoring liver function tests helps detect any signs of liver damage early, allowing for appropriate interventions to be implemented promptly.

3. A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before leaving the hospital. How should the PN respond to this client's request?

• A. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one of them.
• B. Encourage him to wait until he is at home to take a medication that might impair reasoning.
• C. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
• D. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.

Correct answer: D

Rationale: Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client about the pain he is experiencing before giving the medication. The client's need for pain medication should be addressed, and pain medication should not be withheld because he is going home.

4. A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: B

Rationale: Corrected Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide. Incorrect Rationale for Other Choices: A. Hyperkalemia is not typically associated with hydrochlorothiazide use; instead, it is more commonly linked to medications like ACE inhibitors or potassium-sparing diuretics. C. Hypernatremia is unlikely with hydrochlorothiazide use as it tends to cause sodium loss. D. Hyponatremia is more commonly associated with conditions where there is excessive water intake or syndrome of inappropriate antidiuretic hormone secretion (SIADH), rather than with hydrochlorothiazide use.

5. When educating a client about the adverse effects of conjunctivitis, what is a serious condition that requires prompt attention?

• A. Contact lens irritation
• B. Decreased sex drive
• C. Brown spots on the skin
• D. Epigastric pain unrelieved by antacids

Correct answer: D

Rationale: Epigastric pain unrelieved by antacids is a concerning symptom that may indicate a more serious underlying condition such as a perforated ulcer. This symptom requires immediate medical attention to prevent further complications.

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