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 with hypertension is prescribed atenolol. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Dry mouth
• D. Hypotension

Correct answer: A

Rationale: When a client is prescribed atenolol, a beta-blocker, the nurse should monitor for bradycardia, which is a potential side effect. Atenolol works by slowing the heart rate, so monitoring the client's heart rate is essential to detect and manage bradycardia promptly.

3. The practical nurse administered 15 units of NPH insulin subcutaneously to a client before they consumed their breakfast at 7:30 AM. At what time is the client at an increased risk for a hypoglycemic reaction?

• A. 8:30 to 11:30 AM
• B. 3:30 to 7:30 PM
• C. 9:30 PM to midnight
• D. 1:00 to 5:00 AM

Correct answer: B

Rationale: NPH insulin, an intermediate-acting type, peaks approximately 8 to 12 hours after subcutaneous administration. Considering this, the client is most likely to experience a hypoglycemic reaction between 3:30 and 7:30 PM, making option B the correct answer. Choices A, C, and D are incorrect because they fall outside the peak time for a hypoglycemic reaction after administering NPH insulin.

4. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?

• A. Increased appetite
• B. Dry mouth and increased thirst
• C. Tremors and polyuria
• D. Constipation

Correct answer: B

Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.

5. A client has been taking simvastatin for 3 days and calls the nurse at the clinic to report extreme muscle tenderness and pain. Which is the most appropriate action?

• A. Notify the health care provider.
• B. Review the medication with the client.
• C. Advise the client to avoid grapefruit juice.
• D. Remind the client to limit physical activity until evaluated by the health care provider.

Correct answer: A

Rationale: Extreme muscle tenderness and pain in a client taking simvastatin could indicate rhabdomyolysis, a serious condition. Promptly notifying the health care provider is crucial to evaluate and manage this potential medical emergency. Reviewing the medication with the client may not address the urgency of the situation. Advising the client to avoid grapefruit juice is not directly related to the client's current symptoms. Reminding the client to limit physical activity until evaluated by the health care provider is not appropriate as the client's symptoms should be assessed by a professional first.

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