Nursing Elites

1. A nurse is reviewing the medication metformin with a client who has diabetes. Which of the following side effects should the nurse discuss?

• A. Gastrointestinal upset
• B. Increased appetite
• C. Weight loss
• D. Frequent urination

Correct answer: A

Rationale: The correct answer is A: Gastrointestinal upset. Metformin can cause gastrointestinal upset, especially when first starting therapy. It is important to take it with food to reduce these effects. Increased appetite (choice B) and weight loss (choice C) are not common side effects of metformin but may occur due to improved blood sugar control. Frequent urination (choice D) is a symptom of uncontrolled diabetes and not a side effect of metformin.

2. A client is prescribed furosemide. Which of the following is a potential side effect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss through urine, causing hypokalemia. Hyperkalemia (choice A) is not a side effect of furosemide. Hyponatremia (choice C) and hypernatremia (choice D) are related to sodium levels rather than potassium, and they are not typically associated with furosemide use.

3. During a change-of-shift assessment, a nurse is evaluating four clients. Which finding should the nurse report to the provider first?

• A. A client with cystic fibrosis who has a productive cough and reports thirst
• B. A client with gastroenteritis who is lethargic and confused
• C. A client with diabetes mellitus whose blood glucose is 185 mg/dL
• D. A client with sickle cell anemia who reports pain 15 minutes after receiving analgesics

Correct answer: B

Rationale: Lethargy and confusion in a client with gastroenteritis are concerning findings that may indicate severe dehydration or electrolyte imbalance, requiring immediate intervention. While the other options are important, they do not pose an immediate life-threatening risk compared to the altered mental status in a client with gastroenteritis.

4. A nurse is teaching a group of assistive personnel (AP) about the expected integumentary changes in older adults. Which should the nurse include?

• A. Increase in elasticity
• B. Decrease in pigmentation
• C. Decrease in elasticity
• D. Increase in moisture levels

Correct answer: C

Rationale: The correct answer is C: 'Decrease in elasticity.' As individuals age, they typically experience a decrease in skin elasticity, leading to sagging skin and increased wrinkles. This change in elasticity can contribute to various skin-related issues such as pressure ulcers and delayed wound healing. Choices A, B, and D are incorrect because older adults do not experience an increase in elasticity or moisture levels, and while there may be changes in pigmentation, the primary change related to aging in the integumentary system is a decrease in elasticity.

5. In orienting new staff nurses to a pediatric intensive care unit, what is an important consideration in providing information to parents of a critically ill child?

• A. Making sure they receive complete information during each encounter
• B. Assessing parents' preferences regarding the amount of information
• C. Allowing parents to observe key aspects of their child's care
• D. Providing patient education brochures explaining ICU protocols

Correct answer: B

Rationale: Assessing parents' preferences about the amount of information is crucial because it allows for individualized care that respects their needs and emotional capacity during a stressful time. Choice A is not ideal as overwhelming parents with complete information during each encounter may not align with their preferences. Choice C, while valuable, may not always be feasible or appropriate due to privacy concerns or medical procedures. Choice D, providing brochures, may not address the specific needs or preferences of each set of parents, making it less effective than assessing individual preferences.

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