Nursing Elites

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

• A. Genital infections
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: The correct answer is A: Genital infections. Dapagliflozin, a medication used in diabetes mellitus type 2, is associated with an increased risk of genital infections. Its mechanism of action involves promoting glucose excretion through the urine, creating a favorable environment for microbial growth in the genital area. Monitoring for genital infections is crucial when a client is prescribed dapagliflozin. Hypoglycemia (choice B) is not a common adverse effect of dapagliflozin since it does not directly lower blood glucose levels. Hyperglycemia (choice C) is also unlikely as dapagliflozin is intended to help lower blood glucose levels. Nausea (choice D) is a less common side effect of dapagliflozin compared to genital infections.

2. A client with rheumatoid arthritis is prescribed sulfasalazine. Which instruction should the nurse include in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid sunlight while taking this medication.
• C. Report any signs of infection to the healthcare provider.
• D. Take this medication on an empty stomach.

Correct answer: A

Rationale: The correct instruction to include in the client's teaching plan regarding sulfasalazine is to take the medication with meals. Taking sulfasalazine with food helps to minimize gastrointestinal upset, which is a common side effect of the medication. Choice B is incorrect because avoiding sunlight is not specifically related to sulfasalazine. Choice C is important but not directly related to the administration of sulfasalazine. Choice D is incorrect because sulfasalazine should be taken with meals to reduce gastrointestinal side effects.

3. A client with diabetes mellitus type 2 is prescribed metformin. What instruction should the nurse include in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid alcohol while taking this medication.
• C. Take this medication on an empty stomach.
• D. Report any signs of lactic acidosis to the healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals. Taking metformin with meals helps to minimize gastrointestinal side effects, which are common with this medication. Choice B, avoiding alcohol, is a good practice due to the increased risk of lactic acidosis when alcohol is consumed with metformin; however, it is not the priority teaching point in this scenario. Taking metformin on an empty stomach (Choice C) is incorrect because it can increase the risk of gastrointestinal side effects. Reporting signs of lactic acidosis (Choice D) is important, but it is more related to monitoring for adverse effects rather than a primary teaching point for administration.

4. Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the healthcare provider?

• A. I should notify the healthcare provider if the color of my urine turns pink.
• B. I should never stop taking this medication abruptly.
• C. I should monitor my glucose levels closely since I am diabetic.
• D. I should take the medicine with antacids if gastric upset occurs.

Correct answer: D

Rationale: The correct answer is D because antacids should not be taken with phenytoin as they can decrease its effects. Taking antacids with phenytoin is not recommended. Choice A is correct; pink discoloration of urine can occur with phenytoin use. Choice B is also correct; abruptly stopping phenytoin can lead to seizures. Choice C is correct; monitoring glucose levels is important as phenytoin can increase glucose levels. Therefore, the statement about using antacids with phenytoin needs clarification.

5. A practical nurse (PN) is reviewing teaching with the client and/or significant others about the concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should the PN reinforce?

• A. Benztropine will reduce olanzapine's side effect of urinary retention.
• B. Benztropine potentiates the effect of olanzapine.
• C. Benztropine is used to control the side effects of olanzapine.
• D. The combined effect of these drugs will modify psychotic behavior.

Correct answer: C

Rationale: The correct answer is C because benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with olanzapine use. Choice A is incorrect because benztropine does not directly reduce olanzapine's side effect of urinary retention. Choice B is incorrect as benztropine does not potentiate the effect of olanzapine; its main role is to counteract extrapyramidal symptoms. Choice D is incorrect because the primary purpose of using benztropine alongside olanzapine is to manage side effects, not specifically to modify psychotic behavior.

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