Nursing Elites

1. A client with type 2 diabetes mellitus is prescribed glipizide (Glucotrol). Which instruction should the nurse include in the teaching plan?

• A. Take the medication before a meal.
• B. Monitor for signs of hypoglycemia.
• C. Avoid alcohol consumption while taking this medication.
• D. Take the medication before bedtime.

Correct answer: B

Rationale: The correct instruction the nurse should include in the teaching plan for a client prescribed glipizide (Glucotrol) is to monitor for signs of hypoglycemia. Glipizide stimulates insulin release from the pancreas, which can lead to hypoglycemia. It is usually taken before a meal, not necessarily on an empty stomach. Alcohol consumption should be avoided to prevent interactions with the medication. Taking the medication before bedtime is not the typical recommendation.

2. After the initial dose, which of the following is the priority assessment for a client being treated for acute congestive heart failure with intravenously administered bumetanide?

• A. Monitoring weight loss
• B. Monitoring temperature
• C. Monitoring blood pressure
• D. Monitoring potassium level

Correct answer: C

Rationale: The correct answer is monitoring blood pressure. Bumetanide is a loop diuretic, and monitoring blood pressure is crucial as hypotension is a common side effect. Hypotension can further worsen the condition of a patient with congestive heart failure, so assessing and managing blood pressure is a priority after administering bumetanide.

3. A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:

• A. Watch for irritability as a side effect.
• B. Take the tablet with a full glass of water.
• C. Take an extra dose if the cough is accompanied by fever.
• D. Crush the sustained-release tablet if immediate relief is needed.

Correct answer: B

Rationale: Guaifenesin is an expectorant used to help loosen mucus and make coughs more productive. Taking it with a full glass of water helps decrease the viscosity of secretions, making it easier to expel mucus from the respiratory tract. It is important not to crush sustained-release tablets, as this can alter the intended release of the medication and lead to potential adverse effects.

4. A nurse is providing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which of the following statements indicates that the client understands the instructions?

• A. I will never be able to drive a car.
• B. My anticonvulsant medication will clear up my skin.
• C. I can't drink alcohol while I am taking my medication.
• D. If I forget my morning medication, I can take two pills at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'I can't drink alcohol while I am taking my medication.' Alcohol can lower the seizure threshold and should be avoided by individuals taking anticonvulsants. Choice A is incorrect because it is an extreme statement and not necessary for someone taking anticonvulsants. Choice B is incorrect as anticonvulsant medications are not used to clear skin conditions. Choice D is incorrect because doubling up medication doses can be harmful and should not be done without healthcare provider approval.

5. A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which medication should be prepared to administer as prescribed to the client?

• A. Calcium chloride
• B. Calcium gluconate
• C. Calcitonin (Miacalcin)
• D. Large doses of vitamin D

Correct answer: C

Rationale: The normal serum calcium level ranges from 8.6 to 10.0 mg/dL. In hypercalcemia, as seen in this client, Calcitonin (Miacalcin) is used to decrease plasma calcium levels by inhibiting bone resorption. Calcium gluconate and calcium chloride are typically used for hypocalcemia, not hypercalcemia. Large doses of vitamin D should be avoided in hypercalcemia as they can exacerbate hypercalcemia by increasing calcium absorption from the intestines.

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