Nursing Elites

1. A client with diabetes mellitus type 2 is prescribed canagliflozin. The nurse should include which instruction in the client's teaching plan?

• A. Report any signs of urinary tract infection.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Avoid taking this medication with grapefruit juice.

Correct answer: A

Rationale: The correct instruction to include in the client's teaching plan is to report any signs of urinary tract infection. Canagliflozin, a medication used in diabetes mellitus type 2, can increase the risk of urinary tract infections. Instructing the client to report any signs of infection is crucial for early intervention and management. Choices B, C, and D are incorrect because there is no specific requirement to take canagliflozin with meals, avoid alcohol, or restrict grapefruit juice consumption while on this medication.

2. A client with a history of heart failure is prescribed digoxin. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Hypertension
• D. Hypotension

Correct answer: A

Rationale: Digoxin, a medication commonly prescribed for heart failure, can lead to bradycardia, characterized by a slow heart rate. Monitoring for bradycardia is crucial to detect and manage this potential side effect early on to prevent complications such as arrhythmias or decreased cardiac output. Tachycardia (choice B) is not typically associated with digoxin use. Hypertension (choice C) and hypotension (choice D) are also not common side effects of digoxin.

3. When administering medications to a group of clients, which client should the nurse closely monitor for the development of acute kidney injury (AKI)?

• A. Lorazepam
• B. Sucralfate
• C. Digoxin
• D. Vancomycin

Correct answer: D

Rationale: Vancomycin is known to be nephrotoxic, which means it can cause damage to the kidneys. Therefore, clients receiving Vancomycin should be closely monitored for signs and symptoms of acute kidney injury (AKI) to ensure early detection and intervention if necessary. Lorazepam, Sucralfate, and Digoxin do not typically cause acute kidney injury, so they are not the priority for monitoring in this scenario.

4. A 6-month-old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse (PN) warrants immediate intervention for signs of digoxin toxicity?

• A. Apical heart rate of 60 beats/min
• B. Sweating across the forehead
• C. Poor sucking effort
• D. Respiratory rate of 30 breaths/min

Correct answer: A

Rationale: A heart rate of 60 beats/min for a 6-month-old infant warrants immediate intervention as it falls below the normal range. The normal heart rate for a 6-month-old is 80 to 150 beats/min when awake, and a rate of 70 beats/min while sleeping is considered within normal limits. Bradycardia (heart rate <60 beats/min) in infants can be a sign of digoxin toxicity, necessitating prompt evaluation and intervention to prevent adverse effects. Sweating across the forehead (Choice B) is a non-specific symptom and may not directly indicate digoxin toxicity. Poor sucking effort (Choice C) and a respiratory rate of 30 breaths/min (Choice D) are not typically associated with digoxin toxicity and do not require immediate intervention in the context of this question.

5. A client with diabetes mellitus type 2 is prescribed glipizide. 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 hypoglycemia to the healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client prescribed glipizide, a sulfonylurea used to lower blood sugar levels, is to take the medication with meals. Taking it with meals helps to minimize the risk of hypoglycemia by ensuring a more balanced effect on blood glucose levels throughout the day. It is important for the client to follow this instruction to maintain stable blood sugar levels and reduce the likelihood of experiencing low blood sugar (hypoglycemia) episodes. Choice B is incorrect because there are no specific contraindications between glipizide and alcohol. Choice C is incorrect as glipizide should not be taken on an empty stomach. Choice D is incorrect as while it is important to report signs of hypoglycemia, the primary focus should be on preventing hypoglycemia by taking the medication with meals.

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