Nursing Elites

1. 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.

2. The healthcare provider is evaluating the effectiveness of metaproterenol for how do you know it's been effective?

• A. Increased heart rate and blood pressure
• B. Decreased white blood cell count
• C. Decreased wheezing upon auscultation
• D. Decreased respiratory rate

Correct answer: C

Rationale: The effectiveness of metaproterenol, a bronchodilator, is assessed by a decrease in wheezing upon auscultation. Wheezing indicates airway constriction, and a reduction in wheezing signifies improved airflow and bronchodilation due to the medication's action. Therefore, choices A, B, and D are incorrect as they do not directly relate to the expected outcome of metaproterenol therapy.

3. How do you determine if the medication is effective for a client with anemia secondary to chronic kidney disease (CKD)?

• A. Food diary shows increased consumption of iron-rich foods
• B. Reports of increased energy levels and decreased fatigue
• C. Hemoglobin level increased to 12 grams/dL
• D. Takes concurrent iron therapy without adverse effects

Correct answer: C

Rationale: The correct answer is C. To assess the effectiveness of medication for anemia in a client with CKD, monitoring hemoglobin levels is crucial. Hemoglobin levels directly indicate the response to treatment and improvement in the condition. An increase in hemoglobin level to 12 grams/dL suggests that the medication is effectively addressing the anemia associated with CKD. Choices A, B, and D are incorrect because increased consumption of iron-rich foods, reports of increased energy levels and decreased fatigue, and tolerance to concurrent iron therapy without adverse effects are not direct indicators of the medication's effectiveness in treating anemia secondary to CKD.

4. When a patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium, the nurse should monitor for potential side effects. The correct answer is dry mouth. Ipratropium can cause dry mouth as a common side effect due to its anticholinergic effects. This side effect can impact the patient's oral health and comfort, requiring close monitoring and appropriate interventions.

• A. Dry mouth
• B. Tachycardia
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: Ipratropium is an anticholinergic medication commonly used in COPD. One of the most common side effects of anticholinergics is dry mouth due to the inhibition of salivary gland function. Tachycardia (Choice B) is not a typical side effect of ipratropium. Insomnia (Choice C) is also not a common side effect of this medication. Increased appetite (Choice D) is not associated with ipratropium use. Therefore, the correct side effect to monitor for in a patient prescribed ipratropium is dry mouth.

5. A client with hypertension is prescribed clonidine. The nurse should monitor for which potential side effect?

• A. Bradycardia
• B. Tachycardia
• C. Dizziness
• D. Hyperglycemia

Correct answer: A

Rationale: When a client is prescribed clonidine, the nurse should monitor for bradycardia as a potential side effect. Clonidine can lead to a decrease in heart rate, thus causing bradycardia. Monitoring the client's heart rate is crucial to detect and manage this adverse effect.

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