Nursing Elites

1. A client with gastroesophageal reflux disease (GERD) is prescribed omeprazole. The nurse should reinforce which instruction?

• A. Take this medication in the morning before breakfast.
• B. Take this medication with meals.
• C. Avoid taking this medication with antacids.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client with GERD prescribed omeprazole is to take the medication in the morning before breakfast. Omeprazole works best when taken on an empty stomach, approximately 30 minutes before the first meal of the day. This timing maximizes its effectiveness in reducing stomach acid production and helps manage symptoms of GERD more efficiently. Choice B is incorrect because taking omeprazole with meals may reduce its efficacy as it needs an empty stomach for optimal absorption. Choice C is incorrect because omeprazole can be taken with or without food, but it should not be taken with antacids as they can affect its absorption. Choice D is incorrect because taking omeprazole at bedtime is less effective compared to taking it before breakfast due to the circadian rhythm of gastric acid secretion.

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

• A. Genital infections
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Genital infections. Dapagliflozin, a medication used in diabetes mellitus type 2, is associated with an increased risk of genital infections. Its mechanism of action involves promoting glucose excretion through the urine, creating a favorable environment for microbial growth in the genital area. Monitoring for genital infections is crucial when a client is prescribed dapagliflozin. Hypoglycemia (choice B) is not a common adverse effect of dapagliflozin since it does not directly lower blood glucose levels. Hyperglycemia (choice C) is also unlikely as dapagliflozin is intended to help lower blood glucose levels. Nausea (choice D) is a less common side effect of dapagliflozin compared to genital infections.

3. 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.

4. A client with a diagnosis of schizophrenia is prescribed aripiprazole. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry mouth
• C. Headache
• D. Increased appetite

Correct answer: A

Rationale: Aripiprazole is known to cause weight gain in patients, so monitoring for changes in weight is essential to assess for this potential side effect and intervene accordingly.

5. A client with heart failure develops hyperaldosteronism. What dietary recommendation is essential for managing this condition?

• A. Limit intake of high potassium foods
• B. Replace salt with salt substitute
• C. Monitor skin for excessive bruising
• D. Cover your skin before going outside

Correct answer: A

Rationale: Hyperaldosteronism can lead to increased potassium retention, which can be problematic for individuals with heart failure. Limiting intake of high potassium foods is crucial to prevent hyperkalemia, a condition that can worsen heart failure. Therefore, advising the client to limit high potassium foods is essential in managing hyperaldosteronism in the setting of heart failure.

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