Nursing Elites

1. A client with a diagnosis of bipolar disorder is prescribed lithium. The nurse should monitor for which potential side effect?

• A. Dry mouth
• B. Hair loss
• C. Weight gain
• D. Tremors

Correct answer: D

Rationale: The correct answer is D: Tremors. When a client is prescribed lithium for bipolar disorder, one common side effect to monitor for is tremors. Tremors are a known adverse effect of lithium therapy and should be monitored closely by healthcare providers. Choice A, dry mouth, is not typically associated with lithium use. Hair loss, as in choice B, is not a common side effect of lithium. Weight gain, as mentioned in choice C, can occur with some medications used to treat bipolar disorder, but it is not a prominent side effect of lithium specifically.

2. A client with diabetes mellitus type 1 is prescribed insulin lispro. When should the nurse instruct the client to administer this medication?

• A. 5-10 minutes before meals
• B. 15 minutes after meals
• C. 30 minutes before meals
• D. 1 hour after meals

Correct answer: A

Rationale: Corrected Rationale: Insulin lispro is a rapid-acting insulin that should be administered 5-10 minutes before meals. This timing helps synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing postprandial hyperglycemia. Choice B, administering 15 minutes after meals, is incorrect because rapid-acting insulins like lispro are meant to act quickly to cover the rise in blood glucose levels after meals. Choices C and D are also incorrect as they do not align with the rapid onset of action required to manage postprandial hyperglycemia in patients with diabetes mellitus type 1.

3. What action should the nurse implement for a female client taking the bisphosphonate medication ibandronate for osteoporosis?

• A. Ask the client to describe how she takes the medication
• B. Reassure the client that the heartburn is temporary
• C. Explain that the use of antacids might be helpful
• D. Encourage the client to increase her calcium intake

Correct answer: A

Rationale: Ensuring correct administration of bisphosphonates, like ibandronate, is essential to maximize effectiveness and minimize potential side effects. By asking the client to describe how she takes the medication, the nurse can assess the client's understanding and adherence to the prescribed regimen, ultimately promoting optimal therapeutic outcomes.

4. A client with a history of deep vein thrombosis is prescribed rivaroxaban. 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: When a client with a history of deep vein thrombosis is prescribed rivaroxaban, the nurse should monitor for signs of bleeding as rivaroxaban increases the risk of bleeding. Common adverse effects of rivaroxaban include bleeding events, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. It is crucial for the nurse to assess for these signs to prevent complications and ensure the client's safety. Choices B, C, and D are incorrect because rivaroxaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. Monitoring for bleeding is essential due to the anticoagulant properties of rivaroxaban.

5. When educating a client about the adverse effects of conjunctivitis, what is a serious condition that requires prompt attention?

• A. Contact lens irritation
• B. Decreased sex drive
• C. Brown spots on the skin
• D. Epigastric pain unrelieved by antacids

Correct answer: D

Rationale: Epigastric pain unrelieved by antacids is a concerning symptom that may indicate a more serious underlying condition such as a perforated ulcer. This symptom requires immediate medical attention to prevent further complications.

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