Nursing Elites

1. A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should include which instruction 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 pancreatitis to the healthcare provider.

Correct answer: D

Rationale: The correct instruction to include in the teaching plan for a client prescribed sitagliptin is to report any signs of pancreatitis to the healthcare provider. Sitagliptin is generally taken with meals to reduce gastrointestinal side effects. Therefore, choice A, 'Take this medication with meals,' is incorrect. Sitagliptin does not have specific interactions with alcohol, so there is no need to advise the client to avoid alcohol, making choice B incorrect. Taking sitagliptin on an empty stomach is not recommended, so choice C is also incorrect. Pancreatitis is a rare but serious side effect of sitagliptin, so it is crucial for the client to report any signs or symptoms to their healthcare provider promptly.

2. A client with chronic kidney disease is prescribed sucroferric oxyhydroxide. What potential side effect should the nurse monitor for?

• A. Diarrhea
• B. Constipation
• C. Nausea
• D. Hyperphosphatemia

Correct answer: A

Rationale: Sucroferric oxyhydroxide is known to cause diarrhea as a side effect. Therefore, the nurse should closely monitor the client for any signs of diarrhea while on this medication to ensure timely intervention and management.

3. 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.

4. A client prescribed glipizide asked why they had to take their insulin orally. How should the practical nurse respond?

• A. Glipizide is not an oral form of insulin and can be used only when some beta cell function is present.
• B. Glipizide is an oral form of insulin and is distributed, metabolized, and excreted in the same manner as insulin.
• C. Glipizide is an oral form of insulin and has the same actions and properties as intermediate insulin.
• D. Glipizide is not an oral form of insulin, but it is effective for those who are resistant to injectable insulins.

Correct answer: A

Rationale: The practical nurse should explain to the client that glipizide is not an oral form of insulin but an oral hypoglycemic agent. Glipizide works by enhancing pancreatic production of insulin when some beta cell function is present. It is not a replacement for insulin but helps the body produce more insulin. Therefore, it can be used when there is still some beta cell function present, unlike insulin which is used when there is a deficiency of endogenous insulin production.

5. A client diagnosed with a sinus infection is prescribed ampicillin sodium. The practical nurse (PN) should instruct the client to notify the healthcare provider immediately if which symptom occurs?

• A. Rash
• B. Nausea
• C. Headache
• D. Dizziness

Correct answer: A

Rationale: The correct answer is A - Rash. Rash is the most common adverse side effect of all generations of penicillin, indicating an allergy to the medication. An allergic reaction could lead to anaphylactic shock, a severe and potentially life-threatening emergency. It is crucial for the client to inform the healthcare provider promptly if a rash develops after taking ampicillin sodium.

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