Nursing Elites

1. A client with Schizophrenia is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

• A. Increase your intake of snacks to prevent weight loss.
• B. Notify the provider if you develop breast enlargement.
• C. Be aware of the possibility of mild seizures while taking this medication.
• D. Expect an increase in libido when taking this medication.

Correct answer: B

Rationale: The correct instruction the nurse should provide to the client taking Risperidone for Schizophrenia is to notify the provider if they develop breast enlargement. Risperidone can lead to an increase in prolactin levels, causing gynecomastia (breast enlargement) and galactorrhea. Therefore, it is crucial for the client to report these manifestations to the healthcare provider for appropriate management. Choices A, C, and D are incorrect. Increasing snack intake to prevent weight loss is not a specific concern related to Risperidone. Mild seizures are not a common side effect of Risperidone, so this instruction is unnecessary. Risperidone is more likely to cause sexual side effects like decreased libido rather than an increase.

2. A client with HIV is beginning therapy with zidovudine. The nurse should monitor the client for which of the following adverse effects of this medication?

• A. Fatigue
• B. Blurred vision
• C. Ringing in the ears
• D. Constipation

Correct answer: A

Rationale: Fatigue is a common adverse effect of zidovudine due to its impact on bone marrow, leading to anemia. Zidovudine is known to suppress bone marrow function, resulting in decreased production of red blood cells and subsequently causing fatigue due to anemia. Monitoring for fatigue is essential to ensure early detection and management of this adverse effect.

3. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.

4. When teaching a client with a new prescription for Furosemide, which instruction should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction for a client with a new prescription for Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects. Choices A, B, and D are incorrect. Taking Furosemide at bedtime (Choice A) is not necessary as it can be taken at any time of the day. Avoiding foods high in potassium (Choice B) is more relevant for clients taking potassium-sparing diuretics. Taking Furosemide with meals (Choice D) may lead to increased diuretic effects and frequent urination.

5. Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?

• A. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
• B. To decrease blood pressure
• C. To increase heart rate
• D. To provide antiplatelet activity in patients who cannot tolerate aspirin

Correct answer: D

Rationale: Clopidogrel (Plavix) is an antiplatelet medication that inhibits platelet aggregation, reducing the risk of blood clots. It is commonly used in patients who have had a stroke and cannot tolerate aspirin due to allergies or intolerances. Choosing clopidogrel in these cases helps prevent further clot formation and reduces the risk of recurrent strokes.

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