Nursing Elites

1. A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the onset of action of the insulin at which of the following times?

• A. 0745
• B. 0700
• C. 0645
• D. 0457

Correct answer: A

Rationale: Insulin glulisine has a rapid onset of action, typically around 15 minutes. Therefore, the nurse should expect the onset around 0745. Choice A is correct as it aligns with the expected onset time. Choices B, C, and D are incorrect as they do not match the typical onset time of insulin glulisine.

2. A client with chronic kidney failure and an AV fistula for hemodialysis is prescribed epoetin alfa. Which of the following therapeutic effects should the nurse include in the teaching?

• A. Reduces blood pressure
• B. Inhibits clotting of fistula
• C. Promotes RBC production
• D. Stimulates growth of neutrophils

Correct answer: C

Rationale: The correct answer is C: Promotes RBC production. Epoetin alfa stimulates erythropoiesis (red blood cell production) to treat anemia associated with chronic kidney failure. This helps in increasing the hemoglobin levels and improving oxygen-carrying capacity. Choices A, B, and D are incorrect as epoetin alfa does not have direct effects on reducing blood pressure, inhibiting clotting of the fistula, or stimulating the growth of neutrophils.

3. A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?

• A. Reye's syndrome
• B. Visual disturbances
• C. Diabetes mellitus
• D. Wilms' tumor

Correct answer: A

Rationale: The correct answer is A: Reye's syndrome. Aspirin use in children with viral infections has been associated with Reye's syndrome, a serious condition that causes swelling in the liver and brain. Visual disturbances (choice B) are not typically associated with aspirin use in children with viral infections. Diabetes mellitus (choice C) and Wilms' tumor (choice D) are not adverse effects of aspirin use in this context.

4. A client with ulcerative colitis has been prescribed sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Jaundice
• B. Constipation
• C. Oral candidiasis
• D. Sedation

Correct answer: A

Rationale: The correct answer is A: Jaundice. Sulfasalazine can cause liver damage as a possible adverse effect, which can manifest as jaundice. Monitoring for jaundice is crucial to detect liver-related adverse effects early. Choices B, C, and D are incorrect. Constipation, oral candidiasis, and sedation are not typically associated with sulfasalazine use. Therefore, the nurse should focus on educating the client specifically about monitoring for jaundice.

5. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

• A. Increases blood pressure
• B. Prevents esophageal bleeding
• C. Decreases heart rate
• D. Reduces ammonia levels

Correct answer: D

Rationale: The correct answer is D: Reduces ammonia levels. Lactulose is used to reduce blood ammonia levels in clients with hepatic encephalopathy. Options A, B, and C are incorrect because lactulose does not have the therapeutic effect of increasing blood pressure, preventing esophageal bleeding, or decreasing heart rate.

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