Nursing Elites

1. A client is starting therapy with Metformin. Which of the following instructions should the nurse include?

• A. Take this medication with your first bite of food.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. Instructing the client to take the medication with the first bite of food helps in achieving optimal effectiveness and minimizes the risk of side effects like nausea or upset stomach. Choice B is incorrect because taking Metformin on an empty stomach can lead to increased gastrointestinal side effects. Choice C is incorrect as there is no specific timing requirement for taking Metformin before bedtime. Choice D is incorrect as Metformin is usually taken daily, not every other day.

2. A nurse is caring for a client who is receiving treatment with vincristine. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Neurotoxicity
• C. Neutropenia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for symptoms such as peripheral neuropathy, muscle weakness, and tingling sensations is crucial. Choices A, C, and D are incorrect because hyperkalemia, neutropenia, and bradycardia are not typically associated with vincristine therapy.

3. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?

• A. Bony orbit
• B. Nasolacrimal duct
• C. Conjunctival sac
• D. Outer canthus

Correct answer: B

Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.

4. Which of the following is not a side effect of the vasodilator Nifedipine?

• A. Nausea
• B. Flushed appearance
• C. Vertigo
• D. Sexual dysfunction

Correct answer: D

Rationale: Sexual dysfunction is not a common side effect of vasodilators such as Nifedipine. Nausea, flushed appearance, and vertigo are more commonly reported side effects associated with this medication. It's essential for healthcare providers to be aware of the potential side effects to monitor and manage them effectively in patients prescribed with Nifedipine.

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

• A. Notify the provider if you plan to become pregnant.
• B. Take the medication 1 hr before you plan to go to sleep.
• C. Allow at least 6 hr for sleep when taking Zolpidem.
• D. To increase the effectiveness of Zolpidem, take it with a bedtime snack.

Correct answer: A

Rationale: Zolpidem is classified under Pregnancy Risk Category C. It is essential for the client to inform the provider if she plans to become pregnant as Zolpidem use during pregnancy may pose risks to the fetus. This precaution allows for appropriate assessment and possible adjustments to the treatment plan to ensure the safety of both the client and the developing baby. Choice B is incorrect because Zolpidem is usually taken immediately before bedtime, not 1 hour before. Choice C is incorrect as Zolpidem is known for its quick onset of action, and the client does not need to allocate a specific amount of time for sleep. Choice D is incorrect as taking Zolpidem with food, especially a bedtime snack, may delay its onset of action.

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