Nursing Elites

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

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

Correct answer: A

Rationale: The correct answer is A: Nausea. Semaglutide, a medication used to treat type 2 diabetes, is known to cause nausea as a potential adverse effect. It is important for the nurse to monitor the client for gastrointestinal symptoms, including nausea, after initiating treatment with semaglutide. While hypoglycemia and hyperglycemia are common concerns in diabetes management, they are not the primary adverse effects associated with semaglutide. Pancreatitis is a serious but rare adverse effect of GLP-1 receptor agonists like semaglutide, which should also be monitored for, but nausea is a more common and immediate concern.

2. A healthy 68-year-old client asks the practical nurse (PN) whether they should take the pneumococcal vaccine. Which statement should the PN offer to the client that provides the most accurate information about this vaccine?

• A. The vaccine is given annually before the flu season to those older than 50 years.
• B. The immunization is recommended for children younger than 2 years old and all adults 65 years or older.
• C. The vaccine is for all ages and is given primarily to those traveling overseas to areas of infection.
• D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.

Correct answer: B

Rationale: The correct answer is B because it is usually recommended that children younger than 2 years old and adults 65 years or older get vaccinated against pneumococcal disease. This is because these age groups are more susceptible to severe complications from the infection. While the vaccine may be recommended for certain individuals with specific medical conditions at any age, the primary target groups are as mentioned in option B. Option A is incorrect as the pneumococcal vaccine is not given annually like the flu vaccine. Option C is incorrect because the vaccine is not primarily for travelers but for certain age groups and individuals with medical conditions at risk. Option D is incorrect as the vaccine's duration of protection can vary, and it is not guaranteed to prevent pneumococcal pneumonia for up to 5 years.

3. 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.

4. A client with a diagnosis of generalized anxiety disorder is prescribed alprazolam. The nurse should instruct the client 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. Alprazolam, a medication commonly used to treat anxiety disorders, can cause drowsiness as a common side effect. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them to ensure their safety.

5. 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.

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