Nursing Elites

1. A client with a history of deep vein thrombosis is prescribed apixaban. 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: The correct answer is A: Increased risk of bleeding. Apixaban is an anticoagulant medication that works by preventing blood clots. While this is beneficial for individuals with a history of deep vein thrombosis, it also increases the risk of bleeding. Therefore, the nurse should monitor the client for signs of bleeding, such as easy bruising, prolonged bleeding from cuts, or blood in the urine or stool. Monitoring for bleeding is crucial to ensure the client's safety and to take appropriate actions if necessary. Choices B, C, and D are incorrect because apixaban does not decrease the risk of bleeding, increase the risk of infection, or decrease the risk of infection. The primary concern when administering apixaban is monitoring for potential bleeding complications.

2. A client with a diagnosis of generalized anxiety disorder is prescribed diazepam. 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: Correct. Diazepam, a medication commonly used to treat anxiety disorders, can lead to drowsiness as a potential side effect. It is important for clients taking diazepam to be cautious about activities that require alertness, such as driving, due to the risk of drowsiness associated with this medication. Choice B, dry mouth, is not typically associated with diazepam use. Choice C, nausea, is less common as a side effect of diazepam compared to drowsiness. Choice D, headache, is also less common and typically not a significant side effect of diazepam.

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

• A. Before meals
• B. After meals
• C. At bedtime
• D. In the morning

Correct answer: C

Rationale: Corrected Rationale: Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours. Administering it at bedtime helps mimic the body's natural insulin secretion pattern and provides optimal blood glucose control during the night and throughout the day. Choice A (Before meals) is incorrect because insulin glargine is not a rapid-acting insulin meant to cover meals. Choice B (After meals) is incorrect as the timing doesn't align with the insulin's mechanism. Choice D (In the morning) is incorrect as administering insulin glargine in the morning may not provide adequate coverage throughout the night and the following day.

4. A client is prescribed amitriptyline for depression. The practical nurse (PN) should monitor for which potential side effect?

• A. Insomnia
• B. Weight loss
• C. Dry mouth
• D. Increased appetite

Correct answer: D

Rationale: The correct answer is 'D: Increased appetite.' Amitriptyline, a tricyclic antidepressant, is known to commonly cause increased appetite, leading to weight gain. Monitoring for increased appetite is crucial as it can impact the client's overall health and well-being. Choice A, 'Insomnia,' is less likely as amitriptyline is more associated with sedative effects. Choice B, 'Weight loss,' is incorrect as weight gain is a more common side effect. Choice C, 'Dry mouth,' is a potential side effect of amitriptyline, but it is not directly related to increased appetite, which is the primary concern in this case.

5. A patient is prescribed sucralfate (Carafate) and asks the nurse what the purpose of taking this medication is. Which is the nurse's best response?

• A. The medication helps reduce bacteria levels in the stomach
• B. The medication helps neutralize gastric acid in the stomach
• C. The medication is used to protect the gastrointestinal mucosa
• D. The medication can reduce the patient's constipation

Correct answer: C

Rationale: The correct answer is C. Sucralfate (Carafate) is used to protect the gastrointestinal mucosa by forming a protective barrier over ulcers. This barrier helps prevent stomach acid from further damaging the ulcers and promotes healing. It does not directly reduce bacteria levels, neutralize gastric acid, or have a direct effect on constipation.

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