Nursing Elites

1. While a client is receiving the medication haloperidol, which client data would indicate to the practical nurse that the medication is therapeutic?

• A. The client has maintained consistent weight loss of 2 pounds per week.
• B. The client has demonstrated a decrease in paranoid behaviors.
• C. The client's blood pressure has remained within normal limits.
• D. The client's fasting blood glucose has remained below 120 mg/dL.

Correct answer: B

Rationale: When a client is taking haloperidol, a therapeutic response involves a decrease in symptoms such as paranoia, hallucinations, delusions, and emotional excitement. These improvements indicate that the medication is effectively managing the client's condition. Monitoring for a reduction in paranoid behaviors helps the practical nurse assess the medication's effectiveness in addressing the client's psychiatric symptoms.

2. The practical nurse administers lactulose to a client. Which client outcome would indicate a therapeutic response?

• A. An increase in urine output
• B. Two to three soft stools per day
• C. Absence of nausea
• D. Decreased serum potassium

Correct answer: B

Rationale: Lactulose is a type of laxative that works by preventing the absorption of ammonia in the colon, leading to increased water absorption in the stool and softening of the stool. The therapeutic response to lactulose is indicated by the passage of two to three soft stools per day, showing that the medication is effectively promoting bowel movements.

3. A patient is prescribed sucralfate (Carafate) and asks the nurse what the purpose of taking this medication is. Which is the nurse's best response?

• A. The medication helps reduce bacteria levels in the stomach
• B. The medication helps neutralize gastric acid in the stomach
• C. The medication is used to protect the gastrointestinal mucosa
• D. The medication can reduce the patient's constipation

Correct answer: C

Rationale: The correct answer is C. Sucralfate (Carafate) is used to protect the gastrointestinal mucosa by forming a protective barrier over ulcers. This barrier helps prevent stomach acid from further damaging the ulcers and promotes healing. It does not directly reduce bacteria levels, neutralize gastric acid, or have a direct effect on constipation.

4. 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.

5. What information should the practical nurse provide to a female client who started taking an oral sulfonamide for a urinary tract infection the previous day and reports slight anorexia, while also experiencing urinary frequency?

• A. Take the medication with an antacid instead of cranberry juice to reduce the anorexia.
• B. Continue to take the medication with a sip of cranberry juice, restricting fluids until the frequency is controlled.
• C. Continue to drink cranberry juice, but take the medicine on an empty stomach with a full glass of water.
• D. Take the medication with a spoonful of ice cream or applesauce and avoid drinking cranberry juice.

Correct answer: C

Rationale: The practical nurse should advise the client to take sulfonamides with a full glass of water to help prevent crystalluria. It is essential to take the medication on an empty stomach, ideally 1 hour before eating or 2 hours after eating to maximize its absorption and effectiveness. Continuing to drink cranberry juice is beneficial, but it is important to take the medicine separately to enhance its therapeutic action.

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