Nursing Elites

1. A client with long-standing obesity has been prescribed phentermine/topiramate-ER. What statement by the client suggests that further health education is necessary?

• A. I'm so relieved to start this medication. I really don't like having to exercise or change what I eat.
• B. It's hard to believe that there are actually medications that can treat obesity.
• C. I'm a bit nervous to start this medication because I know I'll need blood tests sometimes.
• D. I'm going to have to do some rearranging of my finances to make sure I can afford this medication.

Correct answer: A

Rationale: Choice A suggests the need for further health education as the client expresses a reluctance to exercise or change dietary habits, indicating a lack of understanding about the importance of lifestyle modifications in conjunction with medication for effective weight management. It is important for the client to comprehend that a holistic approach, including lifestyle changes, is crucial for successful obesity treatment and long-term health benefits.

2. A patient with bipolar disorder is prescribed valproic acid. What is an important side effect for the nurse to monitor?

• A. Hypertension
• B. Liver toxicity
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Liver toxicity. Valproic acid is known to potentially cause liver toxicity. Monitoring liver function tests regularly in patients taking valproic acid is crucial to detect any signs of liver damage early and prevent serious complications.

3. The nurse is planning care for a client with cirrhosis of the liver. Which intervention should the nurse include to reduce the risk of bleeding?

• A. Monitor for signs of infection.
• B. Limit the client's dietary protein intake.
• C. Administer vitamin K as prescribed.
• D. Encourage the client to increase fluid intake.

Correct answer: C

Rationale: Administering vitamin K as prescribed can help reduce the risk of bleeding in clients with cirrhosis by promoting clotting factor production. Cirrhosis often leads to impaired liver function, affecting the synthesis of clotting factors. Vitamin K supplementation helps in the production of these essential clotting factors, thus reducing the risk of bleeding in clients with cirrhosis. Monitoring for signs of infection (Choice A) is important for overall care but not directly related to reducing the risk of bleeding in cirrhosis. Limiting dietary protein intake (Choice B) may be necessary in some cases of cirrhosis but does not directly address the risk of bleeding. Encouraging increased fluid intake (Choice D) is beneficial for various aspects of health but does not specifically target the risk of bleeding in cirrhosis.

4. During an admission physical assessment, the nurse is examining a newborn who is small for gestational age (SGA). Which finding should the nurse report immediately to the pediatric healthcare provider?

• A. Heel stick glucose of 65 mg/dL.
• B. Head circumference of 35 cm (14 inches).
• C. Widened, tense, bulging fontanel.
• D. High-pitched shrill cry.

Correct answer: C

Rationale: A widened, tense, bulging fontanel is a critical finding in a newborn as it can indicate increased intracranial pressure. This condition requires immediate attention and intervention to prevent further complications. Monitoring fontanel status is crucial in assessing the newborn's neurological well-being and ensuring early detection of potential issues.

5. A patient with tuberculosis is started on rifampin. What advice should the nurse provide?

• A. Limit intake of green leafy vegetables.
• B. Expect orange-red discoloration of body fluids.
• C. Avoid exposure to sunlight.
• D. Take the medication with antacids.

Correct answer: B

Rationale: The correct advice for a patient starting rifampin is to expect orange-red discoloration of body fluids. Rifampin can cause harmless orange-red discoloration of body fluids, which may include urine, sweat, saliva, and tears. It is important for the patient to be aware of this side effect as it can stain clothing and contact lenses. Limiting the intake of green leafy vegetables is not necessary with rifampin. Avoiding exposure to sunlight is more commonly associated with other medications like tetracyclines, not rifampin. Taking rifampin with antacids is not recommended as antacids can reduce the absorption of rifampin, decreasing its effectiveness in treating tuberculosis.

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