Nursing Elites

1. 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.

2. A client is prescribed cyclobenzaprine for muscle spasms. The nurse should instruct the client to avoid which substance while taking this medication?

• A. Alcohol
• B. Caffeine
• C. Nicotine
• D. Dairy products

Correct answer: A

Rationale: The correct answer is A: Alcohol. When taking cyclobenzaprine, it is important to avoid alcohol as it can potentiate the central nervous system depressant effects of the medication. This interaction can lead to increased drowsiness, dizziness, and impaired coordination. Therefore, it is essential for the client to refrain from alcohol consumption while on cyclobenzaprine to prevent these adverse effects and ensure their safety. Choices B, C, and D are incorrect because caffeine, nicotine, and dairy products do not have significant interactions with cyclobenzaprine. While caffeine and nicotine may have stimulant effects that could theoretically counteract some of the sedative effects of cyclobenzaprine, they are not contraindicated. Dairy products, on the other hand, do not interact with cyclobenzaprine and can be consumed safely.

3. Escitalopram is prescribed for a 16-year-old adolescent client who is clinically depressed. Five days later, the parent tells the practical nurse (PN) that the drug is not working because their child is not feeling any better. Which explanation should the PN provide?

• A. It takes 1 to 4 weeks for antidepressant medications to become effective.
• B. The dosage may need to be increased; I will contact your health care provider.
• C. Depression is difficult to treat with drugs alone. Therapy sessions would enhance their effectiveness.
• D. Based on your child's response to this drug, the health care provider is reviewing your medication regimen.

Correct answer: A

Rationale: Antidepressant medications typically require 1 to 4 weeks to reach their full therapeutic effect. It is crucial to educate the family that during the initial week of treatment, the child may experience heightened anxiety. Therefore, it is important to wait for the medication to take its full course before assessing its effectiveness.

4. A client with a diagnosis of generalized anxiety disorder is prescribed lorazepam. The client should be informed that this medication may have which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Lorazepam, a medication commonly used to treat anxiety disorders, can lead to drowsiness as a common side effect. It is important for clients to be aware of this potential effect, and they should be advised to avoid activities like driving until they understand how the medication affects them. Dry mouth, nausea, and headache are possible side effects of other medications but are less commonly associated with lorazepam.

5. A client with a history of stroke is prescribed clopidogrel. The nurse should monitor for which potential side effect?

• A. Bleeding
• B. Weight gain
• C. Nausea
• D. Headache

Correct answer: A

Rationale: When a client with a history of stroke is prescribed clopidogrel, the nurse should monitor for potential side effects, especially bleeding. Clopidogrel is an antiplatelet medication that works by preventing blood clots. One of the major risks associated with clopidogrel is an increased tendency to bleed. Therefore, monitoring for signs of bleeding, such as easy bruising, blood in stool or urine, or prolonged bleeding from minor cuts, is crucial to ensure patient safety and early intervention if needed.

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