Nursing Elites

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

• A. Pancreatitis
• B. Hypoglycemia
• C. Hyperglycemia
• D. Nausea

Correct answer: A

Rationale: When a client with diabetes mellitus type 2 is prescribed linagliptin, the nurse should monitor for pancreatitis as a potential adverse effect. Linagliptin has been associated with rare cases of pancreatitis; therefore, monitoring for signs and symptoms of pancreatitis such as severe abdominal pain, nausea, and vomiting is crucial to ensure timely intervention and management.

2. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?

• A. Increased appetite
• B. Dry mouth and increased thirst
• C. Tremors and polyuria
• D. Constipation

Correct answer: B

Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.

3. A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

• A. Avoid hazardous activities until symptoms subside
• B. Contact the healthcare provider immediately
• C. Continue taking the medication every day
• D. Stop taking the medication until the unpleasant side effects wear off

Correct answer: A

Rationale: The correct instruction for the nurse to provide is to advise the client to avoid hazardous activities until the symptoms of fatigue and dizziness subside. These side effects can impair the client's ability to engage in activities that require alertness and coordination, posing a risk for accidents. Contacting the healthcare provider immediately may not be necessary unless the symptoms worsen or persist. Continuing to take the medication every day without addressing the side effects can lead to further complications. Stopping the medication abruptly without healthcare provider guidance can also be risky and may not be necessary if the symptoms improve with time.

4. While a client is receiving the medication haloperidol, which client data would indicate to the practical nurse that the medication is therapeutic?

• A. The client has maintained consistent weight loss of 2 pounds per week.
• B. The client has demonstrated a decrease in paranoid behaviors.
• C. The client's blood pressure has remained within normal limits.
• D. The client's fasting blood glucose has remained below 120 mg/dL.

Correct answer: B

Rationale: When a client is taking haloperidol, a therapeutic response involves a decrease in symptoms such as paranoia, hallucinations, delusions, and emotional excitement. These improvements indicate that the medication is effectively managing the client's condition. Monitoring for a reduction in paranoid behaviors helps the practical nurse assess the medication's effectiveness in addressing the client's psychiatric symptoms.

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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