Nursing Elites

1. A client who is being discharged to home asks the practical nurse (PN) for a dose of hydrocodone before leaving the hospital. How should the PN respond to this client's request?

• A. Determine if a take-home prescription for hydrocodone was provided and, if so, tell him to take one of them.
• B. Encourage him to wait until he is at home to take a medication that might impair reasoning.
• C. Give him a tablet from the hospital stock and tell him to wait until he is almost home to take it.
• D. Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10.

Correct answer: D

Rationale: Hydrocodone is a narcotic analgesic, and the practical nurse should gather more data from the client about the pain he is experiencing before giving the medication. The client's need for pain medication should be addressed, and pain medication should not be withheld because he is going home.

2. A client with chronic kidney disease is prescribed erythropoietin. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Erythropoietin is a medication commonly used to stimulate red blood cell production in individuals with chronic kidney disease. One of the potential adverse effects of erythropoietin therapy is hypertension. The increased production of red blood cells can lead to elevated blood pressure levels. Therefore, monitoring for hypertension is essential to ensure the client's safety and well-being while on this medication. Choices B, C, and D are incorrect because hypotension, tachycardia, and bradycardia are not typically associated with erythropoietin therapy. Hypertension is the primary adverse effect to monitor in this case.

3. When should a glucagon emergency kit be used for a client with Type 1 diabetes?

• A. During episodes of hypoglycemia
• B. At the onset of signs of diabetic ketoacidosis
• C. Before meals to prevent hyperglycemia
• D. When signs of severe hypoglycemia occur

Correct answer: D

Rationale: A glucagon emergency kit is used when signs of severe hypoglycemia occur in a client with Type 1 diabetes. Glucagon helps raise blood glucose levels in cases of severe hypoglycemia when the individual is unable to take oral glucose. It is crucial to administer glucagon promptly to prevent serious complications associated with low blood sugar levels. Choices A, B, and C are incorrect because a glucagon emergency kit is specifically indicated for severe hypoglycemia, not for general episodes of hypoglycemia, diabetic ketoacidosis, or prevention of hyperglycemia.

4. A client with anxiety is prescribed alprazolam. What instruction should the nurse include in the client's teaching plan?

• A. Take this medication with food.
• B. Avoid activities that require alertness.
• C. Do not stop taking this medication abruptly.
• D. This medication may cause drowsiness.

Correct answer: C

Rationale: The correct answer is C: 'Do not stop taking this medication abruptly.' Alprazolam should not be stopped suddenly as it can lead to withdrawal symptoms. It is important for clients to taper off the medication gradually under medical supervision to prevent adverse effects. Choices A, B, and D are incorrect. Choice A is irrelevant to alprazolam administration instructions. Choice B, 'Avoid activities that require alertness,' is not the priority teaching point for alprazolam. Choice D, 'This medication may cause drowsiness,' is a common side effect of alprazolam but not the most critical instruction to include in the teaching plan.

5. A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?

• A. Determine if the medication is being taken correctly
• B. Provide instructions on managing these side effects
• C. Schedule an appointment for evaluation by the healthcare provider
• D. Advise stopping the medication until the unpleasant side effects wear off

Correct answer: B

Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.

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