Nursing Elites

1. The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?

• A. Administer the medication within 60 minutes before the morning and evening meal.
• B. Withhold the medication and question the prescription with the healthcare provider.
• C. Monitor the client for gastrointestinal side effects after administration of the medication.
• D. Withdraw the insulin from the Penlet into an insulin syringe to prepare for administration.

Correct answer: B

Rationale: Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Choice A is incorrect because exenatide should not be administered to a client with type 1 diabetes mellitus who takes insulin. Choice C is not the most appropriate initial action when the prescription is not suitable for the client. Choice D is unrelated to the administration of exenatide. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.

2. A client with hypertension is prescribed losartan (Cozaar). Which instruction should the nurse include in the teaching plan?

• A. Avoid foods high in potassium.
• B. Take the medication with grapefruit juice.
• C. Monitor blood pressure weekly.
• D. Report any swelling of the lips or face.

Correct answer: D

Rationale: The correct instruction for a client prescribed losartan (Cozaar) is to report any swelling of the lips or face. Losartan can cause angioedema, which is a serious side effect that requires immediate medical attention. Clients do not need to avoid potassium-rich foods unless specifically instructed by their healthcare provider. Taking the medication with grapefruit juice is not recommended as it can interact with certain medications. Additionally, monitoring blood pressure regularly is important, but it should not be limited to a weekly basis; blood pressure should be monitored as per the healthcare provider's recommendation.

3. Which of the following herbal therapies would be prescribed for its use as an antispasmodic? Select all that apply.

• A. Aloe
• B. Kava
• C. Ginger
• D. Chamomile

Correct answer: D

Rationale: Chamomile is known for its antispasmodic properties. It helps in relaxing muscles and reducing spasms. Aloe is a laxative, kava has anxiolytic and sedative effects, and ginger is commonly used to relieve nausea.

4. A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?

• A. My urine may turn brown or green.
• B. This medication is prescribed to help relieve my muscle spasms.
• C. If my vision becomes blurred, I need to be concerned about it.
• D. I need to call my doctor if I experience nasal congestion from this medication.

Correct answer: C

Rationale: The correct answer is C because blurred vision is an adverse effect of methocarbamol (Robaxin) and should be reported to a healthcare provider. Choices A, B, and D are all correct statements. Option A informs the client about a possible discoloration of urine, which is a known side effect. Option B correctly explains the purpose of the medication. Option D correctly advises the client to contact their doctor if they experience nasal congestion, which could indicate an adverse reaction.

5. A client has a prescription for albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs) by metered-dose inhaler. The medications are to be administered by the nurse by giving the:

• A. Albuterol first and then the beclomethasone dipropionate
• B. Beclomethasone dipropionate first and then the albuterol
• C. Alternating a single puff of each, beginning with the albuterol
• D. Alternating a single puff of each, beginning with the beclomethasone dipropionate

Correct answer: A

Rationale: Albuterol, as a bronchodilator, should be administered first to help open up the airways, followed by beclomethasone dipropionate to reduce inflammation in the airways. This sequence ensures optimal therapeutic effects of the medications.

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