Nursing Elites

1. A client has a new prescription for metformin. Which of the following should the nurse educate the client about?

• A. It can cause weight gain
• B. It should be taken with meals
• C. It is an injectable medication
• D. It can cause hypoglycemia

Correct answer: B

Rationale: The correct answer is B: 'It should be taken with meals.' Metformin should be taken with meals to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect because metformin is actually associated with weight loss or weight neutrality. Choice C is incorrect as metformin is typically taken orally and not via injection. Choice D is also incorrect because metformin is not known to cause hypoglycemia as a primary side effect.

2. A nurse is performing a focused assessment for a client who has dysrhythmias. What indicates ineffective cardiac contractions?

• A. Increased blood pressure
• B. Pulse deficit
• C. Normal heart rate
• D. Elevated oxygen saturation

Correct answer: B

Rationale: The correct answer is B: Pulse deficit. A pulse deficit is a significant finding in clients with dysrhythmias, indicating ineffective cardiac contractions. Pulse deficit occurs when there is a difference between the apical and radial pulses, suggesting that not all heart contractions are strong enough to produce a pulse that can be felt peripherally. Increased blood pressure (choice A) may occur due to various factors and is not a direct indicator of ineffective cardiac contractions. Similarly, a normal heart rate (choice C) and elevated oxygen saturation (choice D) do not specifically point towards ineffective cardiac contractions; they can be present in individuals with dysrhythmias but do not directly indicate ineffective cardiac contractions.

3. A nurse is caring for a client with a recent diagnosis of myasthenia gravis. Which of the following medications should the nurse expect to administer?

• A. Methotrexate
• B. Pyridostigmine
• C. Baclofen
• D. Atropine

Correct answer: B

Rationale: Pyridostigmine is the drug of choice for treating myasthenia gravis because it enhances communication between nerves and muscles by inhibiting acetylcholinesterase. Methotrexate (choice A) is not indicated for myasthenia gravis but is used in conditions like rheumatoid arthritis. Baclofen (choice C) is a muscle relaxant used for conditions like spasticity. Atropine (choice D) is not typically used in myasthenia gravis as it can worsen muscle weakness.

4. A nurse is reviewing laboratory results for a client who has chronic kidney disease. Which of the following findings should the nurse expect?

• A. Hypernatremia
• B. Hypocalcemia
• C. Low potassium
• D. Low magnesium

Correct answer: B

Rationale: In chronic kidney disease, the kidneys have impaired ability to activate vitamin D, leading to decreased production of calcitriol. Calcitriol is essential for calcium absorption in the intestines. Therefore, hypocalcemia is a common finding in chronic kidney disease. Hypernatremia (increased sodium levels) is not typically associated with chronic kidney disease. Low potassium and low magnesium are possible electrolyte imbalances in chronic kidney disease, but they are not as directly related to the impaired activation of vitamin D as hypocalcemia.

5. A nurse is caring for a client who has been prescribed methadone. Which of the following client statements indicates a need for further teaching?

• A. I understand methadone slows my breathing.
• B. I understand methadone may cause me to have trouble sleeping.
• C. I will avoid alcohol while I’m taking this medication.
• D. I’ll change positions slowly, especially when standing.

Correct answer: B

Rationale: The correct answer is B because methadone typically causes sedation and respiratory depression, not trouble sleeping. The statement about trouble sleeping indicates a need for further teaching. Choices A, C, and D are incorrect because understanding that methadone slows breathing, avoiding alcohol while taking the medication, and changing positions slowly to prevent dizziness are all appropriate client statements when prescribed methadone.

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