Nursing Elites

1. A client is prescribed diazepam for muscle spasms. What instruction should the nurse include in the client's teaching plan?

• A. Avoid drinking alcohol
• B. Take with food to avoid gastrointestinal upset
• C. Increase fluid intake
• D. Take medication with grapefruit juice

Correct answer: A

Rationale: The correct instruction for a client prescribed diazepam for muscle spasms is to avoid drinking alcohol. Diazepam can cause drowsiness and enhance the effects of alcohol, leading to increased sedation and impaired cognitive function. Clients should be advised to avoid alcohol consumption while taking diazepam to prevent these adverse effects and ensure their safety.

2. A client has metoprolol prescribed. The nurse should reinforce instructions that this medication has which potential adverse effect?

• A. Anxiety
• B. Tachycardia
• C. Sexual dysfunction
• D. Acute renal failure

Correct answer: C

Rationale: The correct answer is C: Sexual dysfunction. Metoprolol, a beta-blocker, can cause sexual dysfunction as an adverse effect. It is important for the nurse to educate the client about this potential side effect. Choice A is incorrect because metoprolol can cause depression, not anxiety. Choice B is incorrect as tachycardia is not an adverse effect of metoprolol; instead, it can lead to bradycardia. Choice D is incorrect because acute renal failure is not typically associated with the use of beta-blockers.

3. A client with major depressive disorder is prescribed bupropion. Which statement by the client indicates the need for further teaching?

• A. This medication may cause weight gain.
• B. This medication may take several weeks to take effect.
• C. I should avoid alcohol while taking this medication.
• D. I should take this medication in the morning with food.

Correct answer: A

Rationale: The correct answer is A because bupropion is associated with weight loss rather than weight gain. It is important for the client to be aware of this potential side effect. Choice B is correct because bupropion may take several weeks to exhibit its full therapeutic effects. Choice C is also accurate as alcohol consumption should be avoided while taking bupropion due to the risk of seizures. Choice D is correct as taking bupropion in the morning with food can help reduce the risk of gastrointestinal side effects.

4. A client who takes metformin for diabetes mellitus type 2 is nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?

• A. NPO except for metformin and regular snacks
• B. NPO except for oral antidiabetic agent
• C. Novolin-N insulin subcutaneously twice daily
• D. Regular insulin subcutaneously per sliding scale

Correct answer: D

Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is crucial to manage their glucose levels effectively. The best approach in this situation is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications. Choices A and B are incorrect because metformin is typically held when a client is NPO, and oral antidiabetic agents may not provide sufficient glucose control. Choice C is incorrect as Novolin-N insulin given twice daily may not offer the flexibility needed for glucose management in a surgical setting where the client's intake is restricted.

5. 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.

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