Nursing Elites

1. A client has a prescription for Desmopressin for the treatment of Diabetes Insipidus. Which of the following instructions should the nurse include in the teaching?

• A. Decrease fluid intake at the start of treatment.
• B. Monitor for nocturia.
• C. Report a weight loss of 0.5 kg (1.1 lb) per week.
• D. Expect permanent polyuria with this medication.

Correct answer: A

Rationale: Desmopressin is a medication used to reduce diuresis in clients with diabetes insipidus. To prevent water intoxication, clients should be advised to decrease fluid intake at the beginning of treatment. This instruction helps to balance fluid levels in the body and prevent potential complications associated with excessive fluid intake while on Desmopressin therapy. Monitoring for signs of fluid retention, such as weight gain, and adjusting fluid intake accordingly are essential components of client education when initiating treatment with Desmopressin.

2. A client with a new prescription for Escitalopram for the treatment of generalized anxiety disorder is being taught by a healthcare provider. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication on an empty stomach.
• B. I will follow a low-sodium diet while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I should not crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. This gradual reduction helps minimize potential withdrawal symptoms and ensures a safer discontinuation process. Choices A, B, and D are incorrect because taking escitalopram on an empty stomach, following a low-sodium diet, and not crushing the medication are not directly related to the safe and effective use of the medication or its discontinuation process.

3. When teaching a client with a new prescription for Sulfasalazine, which instruction should the nurse include?

• A. Expect orange discoloration of urine and skin.
• B. Increase your intake of high-sodium foods.
• C. Take the medication with a full glass of milk.
• D. Expect your stools to be black and tarry.

Correct answer: A

Rationale: The correct instruction to include when teaching a client with a new prescription for Sulfasalazine is to expect orange discoloration of urine and skin. Sulfasalazine can cause this harmless side effect, which does not necessitate discontinuation of the medication. It is crucial for the nurse to educate the client about this expected outcome to prevent unnecessary concern or discontinuation of the medication. Choices B, C, and D are incorrect. Increasing intake of high-sodium foods is not recommended with Sulfasalazine, as it can worsen certain side effects. Taking the medication with a full glass of milk is not necessary for Sulfasalazine administration. Expecting stools to be black and tarry is not an expected side effect of Sulfasalazine.

4. A healthcare professional is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. How many mL/hr should the IV pump be set to deliver?

• A. 125 mL/hr
• B. 100 mL/hr
• C. 150 mL/hr
• D. 200 mL/hr

Correct answer: A

Rationale: To calculate the flow rate, divide the total volume by the total time: 750 mL / 6 hr = 125 mL/hr. Therefore, the IV pump should be set to deliver 125 mL/hr to infuse D5W 750 mL over 6 hours. Choice B (100 mL/hr) is incorrect because it does not accurately divide the total volume by the total time. Choice C (150 mL/hr) and Choice D (200 mL/hr) are incorrect as they are not the correct flow rates needed to infuse the D5W solution over the specified time period.

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

• A. Take this medication in the morning.
• B. Consume potassium-rich foods.
• C. Take this medication with food.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct answer is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and dehydration. The client should be educated to watch for symptoms like dry mouth, increased thirst, weakness, dizziness, and decreased urine output. Prompt recognition of dehydration signs is crucial for timely intervention and prevention of complications. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide in the morning is not a specific instruction for this medication. While potassium-rich foods can be important when taking certain medications, it is not the priority instruction for Hydrochlorothiazide. Taking this medication with food may help reduce stomach upset but is not the most critical instruction for a diuretic like Hydrochlorothiazide.

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