Nursing Elites

1. A healthcare provider notes that a client is receiving lamivudine (Epivir). The healthcare provider determines that this medication has been prescribed to treat which of the following?

• A. Pancreatitis
• B. Pharyngitis
• C. Tonic-clonic seizures
• D. Human immunodeficiency virus (HIV) infection

Correct answer: D

Rationale: Lamivudine, known by the brand name Epivir, is an antiretroviral medication used in the treatment of human immunodeficiency virus (HIV) infection. This medication helps to inhibit the replication of HIV and improve the immune system function in individuals with HIV. Therefore, the correct answer is option D, Human immunodeficiency virus (HIV) infection.

2. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

• A. Tinnitus
• B. Diarrhea
• C. Constipation
• D. Decreased respirations

Correct answer: A

Rationale: The correct answer is A: Tinnitus. Salicylic acid can lead to systemic toxicity, known as salicylism, which may manifest with symptoms like tinnitus, dizziness, hyperventilation, and mental disturbances. Tinnitus is a common early sign of salicylism and should be monitored closely by the nurse to prevent further complications.

3. A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, 'My chest still hurts.' Select the appropriate actions that the nurse should take.

• A. Call a code blue.
• B. Contact the registered nurse.
• C. Contact the client's family.
• D. Assess the client's pain level.

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to contact the registered nurse. When a client with coronary artery disease experiences chest pain and does not achieve relief after the initial administration of nitroglycerin, it is crucial to inform the registered nurse promptly. Following the usual guideline for nitroglycerin administration, the nurse may administer a second tablet after assessing the client's pain level. The nurse should continue to assess the client's pain and monitor vital signs before each dose administration. Calling a code blue is not warranted at this point, as the client's condition does not indicate an immediate life-threatening emergency. Contacting the client's family is not necessary unless requested by the client.

4. A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?

• A. Take the medication with a full glass of water.
• B. Increase your intake of purine-rich foods.
• C. Stop taking the medication if you experience a gout attack.
• D. Take the medication with or without food.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.

5. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select one that doesn't apply.

• A. Diarrhea can occur secondary to the metformin.
• B. The repaglinide is not taken if a meal is skipped.
• C. The repaglinide is taken 30 minutes before eating.
• D. Nausea and vomiting

Correct answer: D

Rationale: Repaglinide is a rapid-acting oral hypoglycemic that should be taken before meals and withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide, so carrying a simple sugar is essential. Metformin decreases hepatic glucose production and can cause diarrhea. Muscle pain may occur as an adverse effect and should be reported to the HCP.

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