Nursing Elites

1. A home health care nurse observes that a client with Parkinson's syndrome is experiencing increased tremors and difficulty in movement. What should the nurse do in response to this finding?

• A. Report the observed finding to the healthcare provider right away
• B. Arrange a medical evaluation so the medication dose can be adjusted
• C. Schedule a return home visit in 2 weeks to monitor
• D. Explain that this is an expected progression of Parkinson's

Correct answer: B

Rationale: In a client with Parkinson's syndrome experiencing increased tremors and movement difficulty, arranging a medical evaluation is crucial to adjust the medication dose. This proactive approach helps in managing the symptoms effectively. Reporting the finding to the healthcare provider may delay necessary adjustments in treatment. Scheduling a return home visit in 2 weeks may not address the immediate need for medication adjustment. Explaining that the progression is expected without taking action does not address the client's worsening symptoms.

2. When administering medications to a group of clients, which client should the nurse closely monitor for the development of acute kidney injury (AKI)?

• A. Lorazepam
• B. Sucralfate
• C. Digoxin
• D. Vancomycin

Correct answer: D

Rationale: Vancomycin is known to be nephrotoxic, which means it can cause damage to the kidneys. Therefore, clients receiving Vancomycin should be closely monitored for signs and symptoms of acute kidney injury (AKI) to ensure early detection and intervention if necessary. Lorazepam, Sucralfate, and Digoxin do not typically cause acute kidney injury, so they are not the priority for monitoring in this scenario.

3. What instruction should the nurse include in the teaching plan for a client with diabetes mellitus type 2 prescribed alogliptin?

• 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: The correct answer is A: Report any signs of pancreatitis to the healthcare provider. Alogliptin is associated with an increased risk of pancreatitis. Therefore, clients should be instructed to report any signs of pancreatitis, such as severe abdominal pain, to their healthcare provider promptly. This is essential for early detection and management of this serious adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with alogliptin.

4. A client with osteoporosis is prescribed raloxifene. The nurse should reinforce which instruction?

• A. Take this medication at the same time each day.
• B. Take this medication with a full glass of water.
• C. Take this medication on an empty stomach.
• D. Take this medication immediately after a meal.

Correct answer: A

Rationale: The correct instruction for a client prescribed raloxifene, a medication used for osteoporosis, is to take it at the same time each day. This consistency helps maintain steady blood levels of the medication, enhancing its effectiveness in managing the condition. Choice B is incorrect because raloxifene does not require a full glass of water for administration. Choice C is incorrect as raloxifene should not be taken on an empty stomach. Choice D is incorrect as raloxifene should not be taken immediately after a meal.

5. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. The nurse should instruct the client to report which potential side effect?

• A. Dry mouth
• B. Blurred vision
• C. Nausea
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Dry mouth. Tiotropium, a commonly prescribed medication for COPD, can cause dry mouth as a side effect. While it may not be severe, clients should report it if it becomes bothersome. Dry mouth is a common side effect of tiotropium due to its anticholinergic properties. Blurred vision, nausea, and tachycardia are not typically associated with tiotropium use in the context of COPD.

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