Nursing Elites

1. A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?

• A. Keep insulin vials refrigerated at all times.
• B. Rotate the insulin injection sites systematically.
• C. Increase the amount of insulin before unusual exercise.
• D. Monitor the urine acetone level to determine the insulin dosage.

Correct answer: B

Rationale: When a client is stabilized with daily insulin injections, it is crucial to rotate the injection sites systematically. This practice helps prevent the development of lipodystrophy, which can affect insulin absorption and lead to inconsistent glucose control. Additionally, rotating sites minimizes discomfort and tissue damage, ensuring optimal insulin delivery and effectiveness.

2. A client is prescribed metronidazole (Flagyl) for a trichomoniasis infection. Which of the following should the nurse include in the teaching plan?

• A. Avoid consuming alcohol while taking this medication.
• B. Take the medication with food.
• C. Increase fluid intake to prevent kidney stones.
• D. Report any gastrointestinal upset to the healthcare provider.

Correct answer: A

Rationale: The correct answer is A. Metronidazole (Flagyl) can cause a disulfiram-like reaction when taken with alcohol, resulting in severe nausea, vomiting, and headache. Therefore, the client should be advised to avoid alcohol while taking this medication to prevent adverse effects. Avoiding alcohol is crucial to prevent these reactions and ensure the effectiveness of the treatment. The other options are not directly related to the specific medication or the condition being treated.

3. When caring for a client with cancer receiving cisplatin, what adverse effects should the nurse monitor for? Select all that apply.

• A. Tinnitus
• B. Insomnia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: Cisplatin, a chemotherapy medication, can lead to various adverse effects, including ototoxicity manifesting as tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Therefore, the nurse should closely monitor for these side effects during the client's treatment.

4. Heparin sodium is prescribed for the client. The nurse expects that the healthcare provider will prescribe which of the following to monitor for a therapeutic effect of the medication?

• A. Hematocrit level
• B. Hemoglobin level
• C. Prothrombin time (PT)
• D. Activated partial thromboplastin time (aPTT)

Correct answer: D

Rationale: The correct answer is D, activated partial thromboplastin time (aPTT). Heparin affects the intrinsic pathway of coagulation. Monitoring aPTT helps ensure that heparin sodium is within the therapeutic range to prevent clot formation. Hematocrit and hemoglobin levels assess red blood cell concentrations and are not specific to monitoring heparin therapy. Prothrombin time (PT) is used to monitor the therapeutic effect of warfarin sodium, which affects the extrinsic pathway of coagulation, not heparin.

5. When is the best time for a client to take a daily dose of prednisone?

• A. At noon
• B. At bedtime
• C. Early morning
• D. Anytime, at the same time each day

Correct answer: C

Rationale: The correct time for a client to take a daily dose of prednisone is early morning. Corticosteroids like prednisone should be taken in the morning to mimic the body's natural hormone release pattern. This timing helps reduce the risk of disrupting the body's internal clock and minimizes the potential for insomnia or other sleep disturbances.

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