Nursing Elites

1. The nurse is preparing a client with chronic obstructive pulmonary disease, which medication should the nurse review with the client to manage this?

• A. Guaifenesin
• B. Prednisone
• C. Salmeterol
• D. Tiotropium

Correct answer: D

Rationale: Tiotropium is commonly used for COPD management.

2. Prior to administration of the initial dose of the GI agent misoprostol, which information should the nurse obtain from the client?

• A. Taking an anti-emetic medication
• B. History of glaucoma
• C. Currently pregnant
• D. Allergy to aspirin

Correct answer: C

Rationale: The correct answer is C. It is crucial for the nurse to obtain information regarding the client's pregnancy status before administering misoprostol, as this medication is contraindicated in pregnancy due to its potential to cause uterine contractions. This can lead to serious complications such as miscarriage or premature birth. Therefore, assessing whether the client is currently pregnant is essential to ensure the safe administration of misoprostol. Choices A, B, and D are not directly related to the administration of misoprostol. While knowing if the client is taking an anti-emetic medication may be relevant to prevent drug interactions, a history of glaucoma and allergy to aspirin are not primary concerns before administering misoprostol.

3. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which sign of digoxin toxicity?

• A. Bradycardia
• B. Tachycardia
• C. Nausea
• D. Vomiting

Correct answer: A

Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a medication used to treat atrial fibrillation, can lead to toxicity manifesting as various cardiac dysrhythmias, with bradycardia being a notable indicator. Monitoring for bradycardia is crucial as it can indicate the need for dosage adjustment or discontinuation of digoxin to prevent adverse effects. Tachycardia, nausea, and vomiting are not typically associated with digoxin toxicity, making them incorrect choices for monitoring in a client receiving this medication.

4. A client with type 2 diabetes mellitus is prescribed semaglutide. The nurse should monitor for which potential adverse effect?

• A. Nausea
• B. Hypoglycemia
• C. Hyperglycemia
• D. Pancreatitis

Correct answer: A

Rationale: The correct answer is A: Nausea. Semaglutide, a medication used to treat type 2 diabetes, is known to cause nausea as a potential adverse effect. It is important for the nurse to monitor the client for gastrointestinal symptoms, including nausea, after initiating treatment with semaglutide. While hypoglycemia and hyperglycemia are common concerns in diabetes management, they are not the primary adverse effects associated with semaglutide. Pancreatitis is a serious but rare adverse effect of GLP-1 receptor agonists like semaglutide, which should also be monitored for, but nausea is a more common and immediate concern.

5. While a client is receiving the medication haloperidol, which client data would indicate to the practical nurse that the medication is therapeutic?

• A. The client has maintained consistent weight loss of 2 pounds per week.
• B. The client has demonstrated a decrease in paranoid behaviors.
• C. The client's blood pressure has remained within normal limits.
• D. The client's fasting blood glucose has remained below 120 mg/dL.

Correct answer: B

Rationale: When a client is taking haloperidol, a therapeutic response involves a decrease in symptoms such as paranoia, hallucinations, delusions, and emotional excitement. These improvements indicate that the medication is effectively managing the client's condition. Monitoring for a reduction in paranoid behaviors helps the practical nurse assess the medication's effectiveness in addressing the client's psychiatric symptoms.

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