Nursing Elites

1. A client with diabetes mellitus type 2 is prescribed empagliflozin. 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. Empagliflozin, a medication commonly used to treat type 2 diabetes, is associated with an increased risk of genital infections. This is due to its mechanism of action, which involves promoting the excretion of glucose through urine, creating a more favorable environment for fungal or bacterial growth in the genital area. Choices B and C, hypoglycemia and hyperglycemia, are less likely adverse effects of empagliflozin. Empagliflozin actually carries a low risk of causing hypoglycemia since it works independently of insulin. Nausea (Choice D) is not a commonly reported adverse effect of empagliflozin, making it an incorrect choice in this scenario.

2. A client with a diagnosis of depression is prescribed escitalopram. Which statement by the client indicates the need for further teaching?

• A. I should take this medication in the morning with food.
• B. This medication may take 1 to 4 weeks to notice improvement in symptoms.
• C. I can stop taking this medication once I feel better.
• D. This medication might make me feel drowsy.

Correct answer: C

Rationale: It is crucial for clients to understand that they should not discontinue escitalopram abruptly, even if they start feeling better. Stopping the medication suddenly can lead to withdrawal symptoms or a relapse of depression. It is essential to complete the full course of treatment as prescribed by the healthcare provider to ensure the best outcomes and prevent potential complications.

3. A client with chronic kidney disease is prescribed cinacalcet. The nurse should monitor for which potential side effect?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hyperkalemia
• D. Hyperphosphatemia

Correct answer: A

Rationale: Corrected Rationale: Cinacalcet is a medication that can lower calcium levels, leading to hypocalcemia. Monitoring for signs of low calcium levels such as muscle cramps, tingling sensations, and abnormal heart rhythms is crucial to prevent complications in clients with chronic kidney disease.\nIncorrect Choices Rationale: B) Hypercalcemia is the opposite effect of cinacalcet; C) Hyperkalemia and D) Hyperphosphatemia are not typically associated with cinacalcet use.

4. A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?

• A. Maintain consistent sodium intake.
• B. Use sunscreen when outdoors.
• C. Return for monthly urinalysis.
• D. Brush and floss teeth daily.

Correct answer: D

Rationale: The correct answer is to reinforce the instruction to brush and floss teeth daily. Phenytoin therapy can lead to gingival hyperplasia (gum disease), which can be prevented by maintaining good oral hygiene practices such as brushing and flossing daily. Choices A, B, and C are incorrect because they are not directly related to the side effects or management of phenytoin therapy. Maintaining consistent sodium intake is not a specific concern with phenytoin. Using sunscreen when outdoors is important to prevent sunburn but is not directly related to phenytoin therapy. Returning for monthly urinalysis may be necessary for other medications, but it is not specifically required for monitoring phenytoin therapy.

5. 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.

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