Nursing Elites

1. What is the primary nursing intervention that the practical nurse should perform before administering ampicillin to a client diagnosed with a urinary tract infection?

• A. Obtain a clean-catch urine specimen.
• B. Assess the urine pH for acidity.
• C. Insert an indwelling catheter.
• D. Assess for complaints of dysuria.

Correct answer: A

Rationale: The correct answer is to obtain a clean-catch urine specimen. Before administering ampicillin to a client with a urinary tract infection, it is crucial to collect a urine specimen to determine the causative organism and evaluate the effectiveness of pharmacological therapy. Assessing the urine pH for acidity (choice B) is not the primary intervention needed before administering ampicillin. Inserting an indwelling catheter (choice C) is invasive and not necessary unless indicated for specific reasons. Assessing for complaints of dysuria (choice D) is important but does not take precedence over obtaining a urine specimen for proper diagnosis and treatment.

2. A client with asthma is prescribed fluticasone. The nurse should instruct the client to use this medication at which time?

• A. During an asthma attack
• B. Twice a day
• C. Once a day
• D. At night before bed

Correct answer: C

Rationale: Fluticasone is a maintenance medication for asthma aimed at controlling symptoms. It should be taken once a day on a regular basis to provide ongoing relief and prevent asthma symptoms, rather than being used to treat acute asthma attacks. Therefore, the correct answer is to use it once a day. Choices A, B, and D are incorrect because using fluticasone during an asthma attack, twice a day, or only at night before bed does not align with the medication's purpose of being a daily maintenance therapy.

3. What action should the nurse implement for a female client taking the bisphosphonate medication ibandronate for osteoporosis?

• A. Ask the client to describe how she takes the medication
• B. Reassure the client that the heartburn is temporary
• C. Explain that the use of antacids might be helpful
• D. Encourage the client to increase her calcium intake

Correct answer: A

Rationale: Ensuring correct administration of bisphosphonates, like ibandronate, is essential to maximize effectiveness and minimize potential side effects. By asking the client to describe how she takes the medication, the nurse can assess the client's understanding and adherence to the prescribed regimen, ultimately promoting optimal therapeutic outcomes.

4. A client with a diagnosis of bipolar disorder is prescribed quetiapine. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Hair loss
• C. Insomnia
• D. Tremors

Correct answer: A

Rationale: When a client with bipolar disorder is prescribed quetiapine, the nurse should monitor for weight gain as a potential adverse effect. Quetiapine is known to commonly cause weight gain, which can have implications for the client's overall health. Regular monitoring of weight can help in early detection and management of this side effect.

5. A client prescribed glipizide asked why they had to take their insulin orally. How should the practical nurse respond?

• A. Glipizide is not an oral form of insulin and can be used only when some beta cell function is present.
• B. Glipizide is an oral form of insulin and is distributed, metabolized, and excreted in the same manner as insulin.
• C. Glipizide is an oral form of insulin and has the same actions and properties as intermediate insulin.
• D. Glipizide is not an oral form of insulin, but it is effective for those who are resistant to injectable insulins.

Correct answer: A

Rationale: The practical nurse should explain to the client that glipizide is not an oral form of insulin but an oral hypoglycemic agent. Glipizide works by enhancing pancreatic production of insulin when some beta cell function is present. It is not a replacement for insulin but helps the body produce more insulin. Therefore, it can be used when there is still some beta cell function present, unlike insulin which is used when there is a deficiency of endogenous insulin production.

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