Nursing Elites

1. 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.

2. When planning to administer the antiulcer GI agent sucralfate, what instruction should the nurse provide regarding administration?

• A. Administer sucralfate once a day
• B. Assess for secondary candida infection
• C. Monitor electrolyte imbalance
• D. Give sucralfate on an empty stomach

Correct answer: D

Rationale: Sucralfate is most effective when taken on an empty stomach. This allows the medication to form a protective layer over the ulcer, promoting healing and symptom relief. Administering sucralfate with or after meals may reduce its efficacy as it may bind to food instead of coating the ulcer site.

3. A client with a history of deep vein thrombosis is prescribed warfarin. The nurse should monitor for which potential adverse effect?

• A. Increased risk of bleeding
• B. Decreased risk of bleeding
• C. Increased risk of infection
• D. Decreased risk of infection

Correct answer: A

Rationale: The correct answer is A: Increased risk of bleeding. Warfarin is an anticoagulant medication that works by prolonging the time it takes for blood to clot. Therefore, a potential adverse effect of warfarin is an increased risk of bleeding. It is crucial for the nurse to monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, nosebleeds, or blood in the urine or stool. Monitoring for these signs is essential to prevent serious complications associated with excessive bleeding. Choices B, C, and D are incorrect because warfarin does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. The primary concern with warfarin therapy is the potential for bleeding complications, so close monitoring for signs of bleeding is essential.

4. A client with rheumatoid arthritis is prescribed methotrexate. What is the most important instruction the practical nurse (PN) should provide to the client?

• A. Take the medication on an empty stomach.
• B. Avoid taking folic acid supplements.
• C. Report any signs of infection immediately.
• D. Increase intake of vitamin C-rich foods.

Correct answer: C

Rationale: Correct Answer: The most important instruction for a client taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. Early detection and treatment of infections are crucial to prevent complications. Instructing the client to be vigilant for signs of infection empowers them to take prompt action, enhancing their overall safety and well-being.

5. Which nursing intervention is most important when caring for a client receiving aspirin 600mg po QID?

• A. Monitor temperature q4h
• B. Use 10-point pain scale to assess pain
• C. Assess for dyspepsia and nausea
• D. Check stool for occult blood

Correct answer: D

Rationale: The correct answer is to check the stool for occult blood when caring for a client receiving aspirin 600mg po QID. Aspirin can lead to gastrointestinal bleeding, and checking for occult blood in the stool is essential to monitor for this serious adverse effect. Monitoring temperature, assessing pain, and checking for dyspepsia and nausea are important interventions but not as critical as monitoring for gastrointestinal bleeding when a client is receiving aspirin.

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