Nursing Elites

1. Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?

• A. An additional dose of prednisone daily
• B. A decreased amount of daily Humulin NPH insulin
• C. An increased amount of daily Humulin NPH insulin
• D. The addition of an oral hypoglycemic medication daily

Correct answer: C

Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.

2. A client is receiving sulfisoxazole. Which of the following should be included in the list of instructions?

• A. Restrict fluid intake.
• B. Maintain a high fluid intake.
• C. If the urine turns dark brown, call the healthcare provider (HCP) immediately.
• D. Decrease the dosage when symptoms are improving to prevent an allergic response.

Correct answer: B

Rationale: When a client is taking sulfisoxazole, it is important to maintain a high fluid intake. Each dose of sulfisoxazole should be taken with a full glass of water, as the medication is more soluble in alkaline urine. Restricting fluid intake is not recommended as it can lead to inadequate hydration. Dark brown urine may be a side effect of some forms of sulfisoxazole but does not necessarily warrant immediate notification of the healthcare provider unless accompanied by other concerning symptoms. Decreasing the dosage when symptoms improve is not advised as it may lead to treatment failure or the development of resistance.

3. Which statement by the client indicates a need for further teaching about the use of metoprolol (Lopressor)?

• A. I will not stop taking the medication abruptly.
• B. I will take my pulse before taking the medication.
• C. I will take the medication with food.
• D. I will take the medication at bedtime.

Correct answer: D

Rationale: The correct answer is D because taking metoprolol (Lopressor) at bedtime is not specifically recommended. Metoprolol should be taken with food to enhance absorption. It is crucial for the client not to stop taking the medication abruptly to prevent rebound hypertension or other adverse effects. Additionally, monitoring the pulse before taking metoprolol is important for assessing its effect on heart rate.

4. The healthcare provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatment?

• A. The medication is an antibacterial.
• B. The medication will help heal the burn.
• C. The medication will permanently stain my skin.
• D. The medication should be applied directly to the wound.

Correct answer: C

Rationale: The correct answer is C. Silver sulfadiazine is an antibacterial used to treat burns, helping in the healing process. It does not permanently stain the skin. Therefore, the statement indicating a lack of understanding is that the medication will permanently stain the skin.

5. Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the client:

• A. To take the medication after meals
• B. To take the medication before meals
• C. To discontinue the medication if a headache occurs
• D. That a reddish-orange discoloration of the urine may occur

Correct answer: D

Rationale: The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse should also educate the client that this discoloration can stain fabric. It is recommended to take the medication after meals to reduce the possibility of gastrointestinal upset. While a headache is an occasional side effect of the medication, it does not warrant discontinuation of the medication.

Similar Questions