Nursing Elites

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

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: Corrected Rationale: When a client with diabetes mellitus type 2 is prescribed saxagliptin, it is crucial to instruct them to report any signs of pancreatitis to the healthcare provider. Saxagliptin can lead to pancreatitis as a side effect, making it essential for clients to be vigilant about recognizing and reporting any related symptoms promptly for timely intervention and management. Choice B is incorrect because saxagliptin can be taken with or without meals. Choice C is not specifically associated with saxagliptin use. Choice D is incorrect as heart failure is not a common side effect of saxagliptin.

2. A client with rheumatoid arthritis is prescribed tofacitinib. What should the nurse include in the client's teaching plan?

• A. Avoid live vaccines while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Report any signs of infection to the healthcare provider.
• D. Avoid sunlight while taking this medication.

Correct answer: A

Rationale: Tofacitinib is an immunosuppressive medication used in rheumatoid arthritis. Patients taking tofacitinib should avoid live vaccines because the medication can weaken the immune system, making live vaccines potentially harmful. It is essential to educate the client on this to prevent any complications related to live vaccines during their treatment.

3. What instruction should the nurse include in the teaching plan for a client prescribed etanercept for rheumatoid arthritis?

• A. Rotate injection sites to prevent irritation.
• B. Take this medication with food to reduce gastrointestinal upset.
• C. Avoid sunlight exposure while on this medication.
• D. Notify the healthcare provider of any signs of infection.

Correct answer: A

Rationale: The correct instruction for a client prescribed etanercept is to rotate injection sites to prevent irritation and ensure proper absorption. Changing sites will help prevent skin irritation and ensure that the medication is absorbed effectively. This practice also reduces the risk of injection site reactions and discomfort. It is essential to follow this instruction to promote optimal medication delivery and minimize adverse effects. Choice B is incorrect because etanercept can be taken with or without food, and it is not specifically indicated to be taken with food to reduce gastrointestinal upset. Choice C is incorrect as there is no specific association between etanercept and sunlight exposure. Choice D is incorrect because while it is important to notify the healthcare provider of signs of infection, this is not the primary instruction related to the administration of etanercept.

4. 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.

5. A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?

• A. Determine if the medication is being taken correctly
• B. Provide instructions on managing these side effects
• C. Schedule an appointment for evaluation by the healthcare provider
• D. Advise stopping the medication until the unpleasant side effects wear off

Correct answer: B

Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.

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