Nursing Elites

1. A client with osteoporosis has a new prescription for alendronate. Which of the following instructions should the nurse provide?

• A. Take the medication with a meal.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Take the medication with a glass of juice.
• D. Take the medication with milk or food.

Correct answer: B

Rationale: The correct instruction for a client taking alendronate is to remain upright for at least 30 minutes after administration. This is essential to prevent esophageal irritation and ensure the medication reaches the stomach properly. Remaining upright reduces the risk of side effects such as esophagitis. Choices A, C, and D are incorrect as alendronate should not be taken with a meal, juice, milk, or food to optimize its absorption and effectiveness.

2. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: The correct answer is C, Regular insulin. Regular insulin, also known as short-acting insulin, typically exhibits a peak effect around 1 to 5 hours following administration. This rapid onset and peak effect make it suitable for managing postprandial glucose levels. Insulin glargine is a long-acting insulin with no pronounced peak effect, making it unsuitable for rapid glucose control within 1 to 5 hours. NPH insulin has an intermediate duration of action and a different peak time frame. Insulin lispro is a rapid-acting insulin that peaks within 30 minutes to 2.5 hours after administration, not within the 1 to 5-hour range.

3. A client with HIV is beginning therapy with zidovudine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Fatigue
• B. Blurred vision
• C. Ringing in the ears
• D. Constipation

Correct answer: A

Rationale: Fatigue is a common adverse effect of zidovudine due to its impact on bone marrow, leading to anemia. Zidovudine is known to suppress bone marrow function, resulting in decreased production of red blood cells and subsequently causing fatigue due to anemia. Monitoring for fatigue is essential to ensure early detection and management of this adverse effect.

4. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Hypernatremia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.

5. A healthcare professional is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare professional to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: Obtaining help from another healthcare professional to confirm the correct client and blood product is crucial in preventing an acute hemolytic reaction during a blood transfusion. This reaction occurs due to ABO or Rh incompatibility. Verifying the correct client and blood product reduces the risk of administering the wrong blood type, which could lead to a life-threatening reaction. Checking for patency of the IV line (Choice A) is important but does not directly prevent an acute hemolytic reaction. Monitoring vital signs (Choice C) is essential for detecting transfusion reactions but does not prevent them. Staying with the client (Choice D) is important for early recognition of adverse reactions but does not address the root cause of preventing an acute hemolytic reaction.

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