Nursing Elites

1. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Somnolence. Somnolence can indicate lactic acidosis, a rare but serious adverse effect of Metformin. Lactic acidosis is manifested by extreme drowsiness, hyperventilation, and muscle pain. Clients should be instructed to report these symptoms to their healthcare provider promptly to prevent further complications.

2. A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?

• A. A headache indicates a serious allergic reaction to nitroglycerin.
• B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
• C. Nitroglycerin does not cause a headache.
• D. The most common side effect of nitroglycerin is a headache.

Correct answer: D

Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.

3. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

• A. 2+ deep tendon reflexes
• B. 2+ pedal edema
• C. 24 mL/hr urinary output
• D. Respirations 12/min

Correct answer: C

Rationale: In a client receiving Magnesium Sulfate IV continuous infusion for Preeclampsia, a urinary output less than 25 to 30 mL/hr is indicative of magnesium sulfate toxicity and should be promptly reported to the provider for further evaluation and management. Therefore, the correct answer is C. Option A, 2+ deep tendon reflexes, are expected findings in a client receiving magnesium sulfate and do not require immediate reporting. Option B, 2+ pedal edema, is a common symptom of preeclampsia and typically does not require immediate intervention. Option D, respirations 12/min, are within the normal range and do not indicate an immediate need for reporting to the provider.

4. A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?

• A. Monitor for signs of bleeding.
• B. Avoid foods high in vitamin K.
• C. Expect to have increased urination.
• D. Take the medication with an antacid.

Correct answer: A

Rationale: The correct instruction for a client starting Warfarin is to monitor for signs of bleeding. Warfarin is an anticoagulant that increases the risk of bleeding; therefore, it is crucial for the client to watch for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stools, or unusual bleeding from gums or nose. If any of these signs occur, the client should promptly report them to their healthcare provider for further evaluation and management. Choices B, C, and D are incorrect because avoiding foods high in vitamin K is related to other medications like Coumadin, increased urination is not a common side effect of Warfarin, and taking Warfarin with an antacid can potentially interfere with its absorption.

5. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital has a long half-life of 4 days, meaning it remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should expect to administer phenobarbital once a day to maintain therapeutic levels and effectiveness. Administering it more than once a day would lead to unnecessary dosing and potential adverse effects as the medication remains active in the body for an extended period.

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