Nursing Elites

1. The practical nurse administers lactulose to a client. Which client outcome would indicate a therapeutic response?

• A. An increase in urine output
• B. Two to three soft stools per day
• C. Absence of nausea
• D. Decreased serum potassium

Correct answer: B

Rationale: Lactulose is a type of laxative that works by preventing the absorption of ammonia in the colon, leading to increased water absorption in the stool and softening of the stool. The therapeutic response to lactulose is indicated by the passage of two to three soft stools per day, showing that the medication is effectively promoting bowel movements.

2. A client with hypertension is prescribed lisinopril. The nurse should monitor for which potential side effect?

• A. Dry cough
• B. Hyperkalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Dry cough. Lisinopril, an ACE inhibitor, is known to cause a persistent dry cough as a common side effect. Monitoring for this adverse effect is crucial because it may lead to non-adherence to the medication. Hyperkalemia (choice B) is a potential side effect of potassium-sparing diuretics, not ACE inhibitors like lisinopril. Hypernatremia (choice C) refers to elevated sodium levels and is not a common side effect of lisinopril. Hyponatremia (choice D) is a condition characterized by low sodium levels and is not a typical side effect of lisinopril. Therefore, the nurse should focus on assessing the client for a dry cough when taking lisinopril.

3. A client who is recovering from an appendectomy is receiving narcotics. Earlier, the nurse witnessed the client's family pushing the pain pump. What should the nurse implement?

• A. Check the client's level of consciousness
• B. Instruct the family not to push the button
• C. Stop the client's basal infusion
• D. Administer a narcotic reversal medication

Correct answer: B

Rationale: Instructing the family not to push the button is necessary to prevent the client from receiving an excessive amount of narcotics, ensuring the safe and appropriate use of the pain pump. Checking the client's level of consciousness may not address the issue of family members pushing the button. Stopping the client's basal infusion is not indicated unless there are specific medical reasons for doing so. Administering a narcotic reversal medication is not necessary at this point as the issue lies with inappropriate use rather than an overdose.

4. A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should include which instruction in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid alcohol while taking this medication.
• C. Take this medication on an empty stomach.
• D. Report any signs of pancreatitis to the healthcare provider.

Correct answer: D

Rationale: The correct instruction to include in the teaching plan for a client prescribed sitagliptin is to report any signs of pancreatitis to the healthcare provider. Sitagliptin is generally taken with meals to reduce gastrointestinal side effects. Therefore, choice A, 'Take this medication with meals,' is incorrect. Sitagliptin does not have specific interactions with alcohol, so there is no need to advise the client to avoid alcohol, making choice B incorrect. Taking sitagliptin on an empty stomach is not recommended, so choice C is also incorrect. Pancreatitis is a rare but serious side effect of sitagliptin, so it is crucial for the client to report any signs or symptoms to their healthcare provider promptly.

5. A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the desired effect of this medication has been achieved?

• A. Dependent edema reduced from +3 to +1.
• B. Serum HDL increased from 35 to 55 mg/dL.
• C. Pulse rate reduced from 150 to 90 beats/min.
• D. Blood pressure reduced from 160/90 to 130/80 mm Hg.

Correct answer: D

Rationale: The correct answer is D. Losartan is prescribed for the treatment of hypertension. The desired effect of losartan is to reduce blood pressure. Therefore, a reduction in blood pressure from 160/90 to 130/80 mm Hg indicates that the desired effect of the medication has been achieved. Choices A, B, and C are not specific effects of losartan and do not directly relate to the expected outcomes of this medication. Dependent edema, serum HDL levels, and pulse rate are not typically influenced by losartan, making choices A, B, and C incorrect.

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