Nursing Elites

1. A client diagnosed with a herniated disc is prescribed hydrocodone/acetaminophen 10 mg/300 mg prn every 4 to 6 hours. As the practical nurse (PN) enters the client's room to administer the requested medication, the client is seen talking and laughing with visiting family. What action should the PN take?

• A. Hold the pain medication until after the visitors leave.
• B. Notify the healthcare provider of the client's drug-seeking behavior.
• C. Administer analgesia as requested by the client.
• D. Inform the client that the medication is not needed based on their behavior.

Correct answer: C

Rationale: The correct action for the PN in this situation is to administer the analgesia as requested by the client. Pain management is based on the client's self-report of pain, which is the most reliable indicator of pain intensity. Analgesics should be given promptly when pain occurs and before it worsens. Following the administration of medication, the PN should discuss the situation with the charge nurse for further guidance or assessment.

2. 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.

3. A client is prescribed an antibiotic for a urinary tract infection (UTI). What instruction should the practical nurse provide to the client to ensure the effectiveness of the medication?

• A. Take the medication with food.
• B. Increase fluid intake.
• C. Complete the full course of the medication.
• D. Avoid dairy products.

Correct answer: C

Rationale: The practical nurse should instruct the client to complete the full course of the antibiotic to ensure the infection is fully treated and to prevent the development of antibiotic resistance. Completing the full course of antibiotics helps to eradicate the infection completely and reduces the risk of bacteria developing resistance to the medication. Choices A, B, and D are not directly related to ensuring the effectiveness of the antibiotic. While taking medication with food or increasing fluid intake can be beneficial in general, the crucial instruction in this case is to complete the full course of the antibiotic.

4. A practical nurse (PN) is preparing to administer enoxaparin to a client. What is the most important action for the PN to take before administering this medication?

• A. Assess the client's blood pressure.
• B. Check the client's platelet count.
• C. Monitor the client's urine output.
• D. Review the client's blood glucose level.

Correct answer: B

Rationale: The correct answer is to check the client's platelet count. Enoxaparin can lead to thrombocytopenia (low platelet count), which can increase the risk of bleeding. Therefore, assessing the platelet count before administering enoxaparin is crucial to ensure that it is within a safe range. Assessing the client's blood pressure (Choice A) is not directly related to enoxaparin administration. Monitoring urine output (Choice C) and reviewing blood glucose levels (Choice D) are not essential actions before administering enoxaparin.

5. A client is admitted to a long-term care facility, and the nurse and a new employee are conducting medication reconciliation. The nurse notes that oxybutynin has been prescribed. The nurse realizes the new employee understands the drug's effect if the new employee explains that this medication is prescribed to treat which condition?

• A. Pain
• B. Depression
• C. Overactive bladder
• D. Chronic anxiety

Correct answer: C

Rationale: The correct answer is C: Overactive bladder. Oxybutynin is prescribed to treat overactive bladder by reducing muscle spasms of the bladder. It is classified as an anticholinergic medication. Choices A, B, and D are incorrect. Oxycodone is an opioid used for pain management. Bupropion is an antidepressant used to treat depression. Buspirone is an anxiolytic used to manage anxiety disorders.

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