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. When a client with hypertension is prescribed losartan, what potential side effect should the nurse monitor for?

• A. Hyperkalemia
• B. Dry cough
• C. Bradycardia
• D. Headache

Correct answer: B

Rationale: The correct answer is B: Dry cough. Losartan, an angiotensin II receptor blocker, can lead to a dry cough as a potential side effect. This occurs due to the drug's effect on the bradykinin pathway in the lungs. Monitoring for a dry cough is essential as it may indicate the need for further evaluation or medication adjustment to manage this adverse reaction.

3. A client with rheumatoid arthritis is prescribed methotrexate. What is the most important instruction the practical nurse (PN) should provide to the client?

• A. Take the medication on an empty stomach.
• B. Avoid taking folic acid supplements.
• C. Report any signs of infection immediately.
• D. Increase intake of vitamin C-rich foods.

Correct answer: C

Rationale: Correct Answer: The most important instruction for a client taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. Early detection and treatment of infections are crucial to prevent complications. Instructing the client to be vigilant for signs of infection empowers them to take prompt action, enhancing their overall safety and well-being.

4. 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.

5. A client with a history of deep vein thrombosis is prescribed warfarin. The nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: The correct answer is A: Increased risk of bleeding. Warfarin is an anticoagulant medication that works by prolonging the time it takes for blood to clot. Therefore, a potential adverse effect of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, nosebleeds, or blood in the urine or stool. Monitoring for these signs is essential to prevent serious complications associated with excessive bleeding. Choices B, C, and D are incorrect because warfarin does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. The primary concern with warfarin therapy is the potential for bleeding complications, so close monitoring for signs of bleeding is essential.

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