Nursing Elites

1. A client has a new prescription for metformin. Which of the following instructions should the nurse include in the teaching?

• A. Take the medication at bedtime
• B. Monitor your blood glucose level before each meal
• C. Stop taking the medication if you develop muscle pain
• D. You may experience diarrhea with this medication

Correct answer: D

Rationale: The correct answer is D: 'You may experience diarrhea with this medication.' Diarrhea is a common side effect of metformin, particularly when initiating the medication. It is important for clients to be aware of this potential side effect. Option A is incorrect because metformin is usually taken with meals to reduce gastrointestinal side effects. Option B is not directly related to metformin use. Option C is incorrect as muscle pain is not a common side effect of metformin and does not warrant stopping the medication.

2. Which of the following characteristics would indicate true labor in a client?

• A. Contractions are irregular and painless
• B. Fetus moves to an anterior position
• C. Bloody show is not present
• D. Contractions are regular in frequency

Correct answer: D

Rationale: The correct answer is D. True labor is characterized by regular contractions that increase in intensity and frequency. These contractions lead to cervical dilation and effacement, signaling the onset of labor. Choice A is incorrect because true labor contractions are regular and painful, not irregular and painless. Choice B is irrelevant to determining true labor. Choice C is also unrelated as the presence or absence of a bloody show does not definitively indicate true labor.

3. A client newly prescribed sertraline is being taught by a nurse. Which statement by the client indicates understanding?

• A. I should take this medication with meals.
• B. I might have trouble sleeping when I start this medication.
• C. I should avoid drinking orange juice.
• D. I will feel better immediately after starting the medication.

Correct answer: B

Rationale: Choice B, 'I might have trouble sleeping when I start this medication,' indicates understanding because insomnia is a common side effect of sertraline, especially when initiating the medication. This statement shows the client comprehends a potential adverse effect and is prepared for it. Choices A, C, and D are incorrect. Taking sertraline with or without meals does not significantly affect its efficacy. There is no specific contraindication about drinking orange juice while on sertraline. Feeling better immediately after starting the medication is unlikely as sertraline usually takes some time to exert its therapeutic effects.

4. A nurse is providing discharge teaching for a client who is postop following abdominal surgery. Which of the following behaviors should the nurse identify as increasing the client's risk for complications?

• A. Walking twice daily
• B. Suppression of the urge to cough
• C. Suppression of the urge to defecate
• D. Lack of ambulation

Correct answer: C

Rationale: The correct answer is C. Suppression of the urge to defecate postoperatively can lead to complications such as constipation, which can increase the risk of complications after abdominal surgery. Walking twice daily (choice A) is actually beneficial for preventing complications such as deep vein thrombosis. Suppression of the urge to cough (choice B) can lead to issues like atelectasis. Lack of ambulation (choice D) can also contribute to complications like pneumonia and blood clots.

5. A nurse is assessing a client with a history of heart failure. Which of the following findings should the nurse monitor?

• A. Increased energy
• B. Peripheral edema
• C. Elevated heart rate
• D. Improved lung sounds

Correct answer: B

Rationale: The correct answer is B: Peripheral edema. In heart failure, the heart's inability to pump effectively can lead to fluid backup, causing swelling in the extremities, known as peripheral edema. Monitoring for peripheral edema is crucial as it is a common sign of worsening heart failure. Choices A, C, and D are incorrect because increased energy, elevated heart rate, and improved lung sounds are not typical findings in heart failure. Increased energy is not usually associated with heart failure, an elevated heart rate may occur as a compensatory mechanism but is not a direct sign of heart failure, and improved lung sounds are not expected in heart failure which often presents with crackles or wheezes due to pulmonary congestion.

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