Nursing Elites

1. A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes asks the practical nurse (PN) if it is safe to continue using artificial tears. What information should the PN provide?

• A. Avoid using artificial tears because they decrease the efficacy of cyclosporine.
• B. Discontinue the use of both products if transient blurring occurs after administration.
• C. Allow a 15-minute interval between the administration of cyclosporine and artificial tears.
• D. Discontinue the use of cyclosporine and artificial tears when tear production reaches a normal level.

Correct answer: C

Rationale: The correct answer is to allow a 15-minute interval between the administration of cyclosporine and artificial tears. Cyclosporine, an ophthalmic emulsion that increases tear production, can be used in conjunction with artificial tears as long as the products are administered 15 minutes apart. This interval helps to prevent any potential interactions between the two products and ensures optimal effectiveness of cyclosporine for treating dry eyes.

2. A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should monitor for which potential adverse effect?

• A. Pancreatitis
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: Corrected Rationale: Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor used in type 2 diabetes, has been associated with rare cases of pancreatitis. Therefore, the nurse should monitor for signs and symptoms of pancreatitis such as severe abdominal pain, nausea, and vomiting. While hypoglycemia is a potential adverse effect of some diabetes medications, it is less common with sitagliptin. Hyperglycemia is the condition being treated and is not an expected adverse effect of sitagliptin.

3. 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.

4. The patient is prescribed cimetidine (Tagamet) orally. What should the nurse consider about administering this drug?

• A. Administer the drug with the first bite of food
• B. Administer the drug immediately after meals
• C. Administer the drug 30 minutes after meals
• D. Administer the drug 30 minutes before meals

Correct answer: D

Rationale: Cimetidine is best absorbed when taken 30 minutes before meals to decrease stomach acid. Administering it before meals allows for optimal absorption and effectiveness of the medication. Choices A, B, and C are incorrect because administering cimetidine with food, immediately after meals, or 30 minutes after meals may not provide the best conditions for absorption. Taking it before meals ensures that the drug is absorbed properly and can exert its intended effects.

5. A client with a diagnosis of schizophrenia is prescribed risperidone. The nurse should monitor for which potential side effect?

• A. Weight gain
• B. Tremors
• C. Insomnia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Weight gain. When a client is prescribed risperidone, monitoring weight is crucial due to the potential side effect of weight gain associated with this medication. This side effect can be significant as it may lead to other health issues. Choice B, Tremors, is not typically associated with risperidone use. Choice C, Insomnia, is less likely to be a direct side effect of risperidone compared to weight gain. Choice D, Hyperglycemia, is a possible side effect of some antipsychotic medications, but it is not commonly associated with risperidone.

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