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. What is a desired outcome of the drug Phenytoin?

• A. Decrease symptoms of PTSD
• B. Resolution of signs of infection
• C. Decrease or cessation of seizures without excessive sedation
• D. Prevention or relief of bronchospasm

Correct answer: C

Rationale: The correct answer is C: Decrease or cessation of seizures without excessive sedation. Phenytoin is primarily used as an antiepileptic medication to manage and prevent seizures. It does not directly impact symptoms of PTSD (Choice A), resolution of signs of infection (Choice B), or prevention or relief of bronchospasm (Choice D). Therefore, the desired outcome of Phenytoin is to control seizures effectively while avoiding excessive sedation.

3. A client is starting therapy with rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The nurse should instruct the client to report fever when starting rituximab therapy. Fever can be a sign of infection, which is a potential complication associated with rituximab. Early detection and treatment of infections are important to ensure the client's safety and well-being. Dizziness, urinary frequency, and dry mouth are not commonly associated with rituximab therapy and are less likely to be directly related to the medication's side effects. Therefore, fever is the most crucial symptom to report to healthcare providers.

4. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: Offering oral hygiene every 2 hours is essential for a client receiving opioid analgesics to prevent dry mouth, nausea, and vomiting, which are common adverse effects associated with opioid use. This intervention promotes comfort and enhances the client's well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate for a client in labor receiving opioid analgesics, as it may be challenging and unnecessary during this time. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's pain level and the duration of action of the opioid. Monitoring fetal heart rate every 2 hours is important during labor, but the priority in this case is to address the client's comfort and well-being by offering oral hygiene.

5. What symptoms should a patient taking Omeprazole report to the healthcare provider?

• A. Black, tarry stools
• B. Diarrhea
• C. Abdominal pain
• D. All of the above

Correct answer: D

Rationale: Patients taking Omeprazole should report black, tarry stools, diarrhea, or abdominal pain to the healthcare provider because these symptoms could indicate serious side effects associated with the medication. Black, tarry stools may suggest gastrointestinal bleeding, diarrhea can be a sign of a gastrointestinal infection or adverse drug reaction, and abdominal pain may indicate underlying issues that need attention. Choosing 'All of the above' is the correct answer as all these symptoms are important to report for proper evaluation and management.

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