Nursing Elites

1. A client is prescribed Metformin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin A1c
• D. Serum creatinine

Correct answer: D

Rationale: The correct answer is D: Serum creatinine. Metformin can potentially cause lactic acidosis, particularly in patients with impaired renal function. Monitoring serum creatinine levels is crucial to assess kidney function and detect any adverse effects of Metformin on renal health. Choices A, B, and C are incorrect as blood glucose, creatine kinase, and hemoglobin A1c levels are not directly monitored to assess for potential adverse effects of Metformin. Blood glucose monitoring is typically done to assess the efficacy of antidiabetic medications like Metformin, while creatine kinase levels are indicative of muscle damage and hemoglobin A1c reflects long-term blood sugar control.

2. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.

3. A nurse is caring for a client in an outpatient facility who has been taking Acarbose for type 2 Diabetes Mellitus. Which of the following laboratory tests should the nurse plan to monitor?

• A. WBC
• B. Serum potassium
• C. Platelet count
• D. Liver function test

Correct answer: D

Rationale: The correct answer is D, Liver function test. Acarbose can cause liver toxicity when taken long-term. Monitoring liver function tests periodically is essential to assess for any potential liver damage. Choices A, B, and C are incorrect because Acarbose does not directly impact white blood cell count, serum potassium levels, or platelet count.

4. A healthcare provider is teaching the parents of a school-age child about transdermal Methylphenidate. Which of the following instructions should the healthcare provider include?

• A. Apply one patch twice a day.
• B. Leave the patch on for 9 hours.
• C. Apply the patch to the child's waist.
• D. Use the opened tray within 6 months.

Correct answer: B

Rationale: When administering transdermal Methylphenidate, it is important to leave the patch on for 9 hours each day to ensure the medication is effective. This duration allows for proper absorption of the medication through the skin. It is crucial for parents to follow this instruction to achieve the desired therapeutic effect for their child.

5. A client has a new prescription for Clopidogrel. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid taking aspirin while on this medication.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking aspirin while on this medication.' Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs also affect platelet function and can further increase the risk of bleeding when combined with Clopidogrel. Therefore, it is important for the client to avoid taking aspirin while on this medication to reduce the risk of excessive bleeding. Choices A, C, and D are incorrect because there is no specific requirement to take Clopidogrel with food, avoid foods high in potassium, or take it at bedtime. The key instruction here is to avoid aspirin to prevent potential bleeding complications.

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