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 practical nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline. Which symptom indicates that the client may be experiencing theophylline toxicity?

• A. Bradycardia
• B. Tremors
• C. Constipation
• D. Hypotension

Correct answer: B

Rationale: Tremors are a common symptom of theophylline toxicity. Other symptoms that may indicate theophylline toxicity include nausea, vomiting, and seizures. Bradycardia, constipation, and hypotension are not typically associated with theophylline toxicity. It is important for the nurse to monitor the client closely for these signs of toxicity and report them promptly to the healthcare provider to prevent further complications.

3. A client whose seizure disorder has been managed with phenytoin is admitted to the emergency department with status epilepticus. Which drug should the practical nurse anticipate being prescribed for administration to treat these seizures?

• A. Phenytoin
• B. Diazepam
• C. Phenobarbital
• D. Carbamazepine

Correct answer: B

Rationale: In the management of status epilepticus, which is a life-threatening condition of prolonged seizures, rapid intervention is crucial. Diazepam is the drug of choice for treating status epilepticus due to its fast onset of action and effectiveness in stopping seizures. It acts by enhancing the inhibitory neurotransmitter GABA to suppress seizure activity quickly. Phenytoin, although used for long-term seizure control, has a slower onset of action and is not the first-line medication for managing status epilepticus.

4. A client with diabetes mellitus type 2 is prescribed glyburide. The nurse should monitor for which potential adverse effect?

• A. Hypoglycemia
• B. Weight gain
• C. Nausea
• D. Hyperglycemia

Correct answer: A

Rationale: The correct potential adverse effect to monitor for when a client with diabetes mellitus type 2 is prescribed glyburide is hypoglycemia. Glyburide can lead to hypoglycemia, particularly in individuals who do not eat regularly, by stimulating the release of insulin from the pancreas, which can lower blood sugar levels. It is crucial for the nurse to monitor for signs and symptoms of hypoglycemia, such as confusion, sweating, and palpitations, to prevent complications and provide timely interventions.

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

• A. Weight gain
• B. Hair loss
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: A

Rationale: The correct answer is A: Weight gain. Valproate is known to cause weight gain as a common adverse effect. It is important for the nurse to monitor the client's weight regularly while on this medication to detect and address any changes that may occur.

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