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 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.

3. A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the desired effect of this medication has been achieved?

• A. Dependent edema reduced from +3 to +1.
• B. Serum HDL increased from 35 to 55 mg/dL.
• C. Pulse rate reduced from 150 to 90 beats/min.
• D. Blood pressure reduced from 160/90 to 130/80 mm Hg.

Correct answer: D

Rationale: The correct answer is D. Losartan is prescribed for the treatment of hypertension. The desired effect of losartan is to reduce blood pressure. Therefore, a reduction in blood pressure from 160/90 to 130/80 mm Hg indicates that the desired effect of the medication has been achieved. Choices A, B, and C are not specific effects of losartan and do not directly relate to the expected outcomes of this medication. Dependent edema, serum HDL levels, and pulse rate are not typically influenced by losartan, making choices A, B, and C incorrect.

4. A client with osteoporosis is prescribed alendronate. The practical nurse (PN) should reinforce which instruction regarding the administration of this medication?

• A. Take the medication with a full glass of water before breakfast.
• B. Take the medication immediately after a meal.
• C. Lie down for 30 minutes after taking the medication.
• D. Crush the medication and mix it with food.

Correct answer: A

Rationale: The correct instruction for administering alendronate is to take the medication with a full glass of water before breakfast. This timing is crucial to ensure proper absorption in the body and reduce the risk of esophageal irritation. Taking it immediately after a meal or lying down for 30 minutes after may affect absorption and increase the risk of adverse effects. It should not be crushed or mixed with food to maintain its effectiveness.

5. A client with a diagnosis of generalized anxiety disorder is prescribed escitalopram. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct potential side effect of escitalopram is drowsiness. Escitalopram is known to cause sedation, so clients should be advised to avoid activities that require mental alertness, such as driving, until they know how the medication affects them. Dry mouth, nausea, and headache are also common side effects of various medications but are not specifically associated with escitalopram.

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