Nursing Elites

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

• A. Weight gain
• B. Liver toxicity
• C. Kidney stones
• D. Bone fractures

Correct answer: B

Rationale: The correct answer is B, liver toxicity. Pioglitazone is known to cause liver toxicity, so it is essential for the nurse to monitor the client's liver function while on this medication. Monitoring liver function tests can help detect any signs of liver damage early, allowing for timely intervention to prevent serious complications.

2. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

3. A client with a diagnosis of generalized anxiety disorder is prescribed escitalopram. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct potential side effect of escitalopram is drowsiness. Escitalopram is known to cause sedation, so clients should be advised to avoid activities that require mental alertness, such as driving, until they know how the medication affects them. Dry mouth, nausea, and headache are also common side effects of various medications but are not specifically associated with escitalopram.

4. When a client with hepatic encephalopathy is receiving lactulose, which parameter is essential to monitor for a response to the drug?

• A. Serum hepatic enzymes
• B. Fingerstick glucose
• C. Stool color and character
• D. Serum electrolytes and ammonia

Correct answer: D

Rationale: In hepatic encephalopathy, the goal of lactulose therapy is to reduce blood ammonia levels by promoting its excretion in the stool. Therefore, monitoring serum electrolytes and ammonia levels is crucial to assess the effectiveness of lactulose in lowering ammonia levels and improving the client's condition. Options A, B, and C are incorrect because serum hepatic enzymes, fingerstick glucose, and stool color/character are not directly related to monitoring the response to lactulose therapy in hepatic encephalopathy.

5. The patient is prescribed cimetidine (Tagamet) orally. What should the nurse consider about administering this drug?

• A. Administer the drug with the first bite of food
• B. Administer the drug immediately after meals
• C. Administer the drug 30 minutes after meals
• D. Administer the drug 30 minutes before meals

Correct answer: D

Rationale: Cimetidine is best absorbed when taken 30 minutes before meals to decrease stomach acid. Administering it before meals allows for optimal absorption and effectiveness of the medication. Choices A, B, and C are incorrect because administering cimetidine with food, immediately after meals, or 30 minutes after meals may not provide the best conditions for absorption. Taking it before meals ensures that the drug is absorbed properly and can exert its intended effects.

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