Nursing Elites

1. A client with diabetes mellitus type 2 is prescribed linagliptin. Which instruction should the nurse include in the client's teaching plan?

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: When a client is prescribed linagliptin, it is crucial to educate them to report any signs of pancreatitis to their healthcare provider. Linagliptin can lead to pancreatitis, making it essential for clients to be vigilant for symptoms such as severe abdominal pain, nausea, and vomiting. Timely reporting of these symptoms can aid in early intervention and management of pancreatitis.

2. Prior to administration of the initial dose of the GI agent misoprostol, which information should the nurse obtain from the client?

• A. Taking an anti-emetic medication
• B. History of glaucoma
• C. Currently pregnant
• D. Allergy to aspirin

Correct answer: C

Rationale: The correct answer is C. It is crucial for the nurse to obtain information regarding the client's pregnancy status before administering misoprostol, as this medication is contraindicated in pregnancy due to its potential to cause uterine contractions. This can lead to serious complications such as miscarriage or premature birth. Therefore, assessing whether the client is currently pregnant is essential to ensure the safe administration of misoprostol. Choices A, B, and D are not directly related to the administration of misoprostol. While knowing if the client is taking an anti-emetic medication may be relevant to prevent drug interactions, a history of glaucoma and allergy to aspirin are not primary concerns before administering misoprostol.

3. In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?

• A. Withdraw ten units of regular insulin from a vial
• B. Withhold the dose until regular insulin is available
• C. Obtain a new vial of regular insulin and withhold
• D. Pull up 30 units from a vial but only administer 10 units

Correct answer: B

Rationale: In insulin administration, regular insulin is typically administered before isophane insulin to manage blood glucose effectively. If regular insulin is not available, it is best to withhold the dose until it can be administered as prescribed. Choice A is incorrect as it suggests withdrawing from a specific vial without specifying regular insulin. Choice C is incorrect as obtaining a new vial of regular insulin may not be necessary if it becomes available shortly. Choice D is incorrect as administering 10 units from a mixture of regular and isophane insulin is not the correct approach.

4. A client is receiving levothyroxine for hypothyroidism. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry skin
• C. Hair loss
• D. Hyperthermia

Correct answer: A

Rationale: Levothyroxine is a medication used to treat hypothyroidism by supplementing the body with thyroid hormone. If the dosage of levothyroxine is too high, it can cause symptoms of hyperthyroidism, including weight loss. Therefore, weight gain can be a potential side effect of levothyroxine if the dosage is excessive.

5. A client with chronic kidney disease is prescribed darbepoetin alfa. The nurse should monitor for which potential side effect?

• A. Hypertension
• B. Hypotension
• C. Hyperkalemia
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. Darbepoetin alfa, used to treat anemia in chronic kidney disease, can lead to hypertension as a side effect. This medication stimulates red blood cell production, which can increase blood pressure. Monitoring blood pressure regularly is crucial to detect and manage this potential adverse effect. Choices B, C, and D are incorrect because hypotension, hyperkalemia, and hyperglycemia are not commonly associated with darbepoetin alfa therapy in chronic kidney disease.

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