Nursing Elites

1. A client with hypertension is prescribed lisinopril. The nurse should monitor the client for which potential side effect?

• A. Cough
• B. Dizziness
• C. Hyperkalemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is A: Cough. Lisinopril is known to cause a persistent dry cough as a side effect. It is essential for the nurse to monitor the client for this adverse reaction as it may lead to discontinuation of the medication. Dizziness, hyperkalemia, and hyponatremia are not typically associated with lisinopril use. Dizziness is more commonly seen with antihypertensives that cause orthostatic hypotension. Hyperkalemia and hyponatremia are not usually linked to lisinopril use.

2. A client who is recovering from an appendectomy is receiving narcotics. Earlier, the nurse witnessed the client's family pushing the pain pump. What should the nurse implement?

• A. Check the client's level of consciousness
• B. Instruct the family not to push the button
• C. Stop the client's basal infusion
• D. Administer a narcotic reversal medication

Correct answer: B

Rationale: Instructing the family not to push the button is necessary to prevent the client from receiving an excessive amount of narcotics, ensuring the safe and appropriate use of the pain pump. Checking the client's level of consciousness may not address the issue of family members pushing the button. Stopping the client's basal infusion is not indicated unless there are specific medical reasons for doing so. Administering a narcotic reversal medication is not necessary at this point as the issue lies with inappropriate use rather than an overdose.

3. A client vomits 30 minutes after receiving a dose of hydromorphone on the first postoperative day. What initial intervention is best for the practical nurse (PN) to implement?

• A. Obtain a prescription for nasogastric intubation.
• B. Administer a prn dose of ondansetron.
• C. Reduce the next scheduled dose of hydromorphone.
• D. Assess the client's abdomen and bowel sounds.

Correct answer: B

Rationale: In this scenario, the client's vomiting is likely due to the hydromorphone administration, indicating a need for an antiemetic such as ondansetron to address the nausea. Nasogastric intubation (Choice A) is not necessary at this point as the client is vomiting, not experiencing an obstruction. While reducing the dose of hydromorphone (Choice C) may be considered later, the immediate focus should be managing the client's symptoms. Assessing the client's abdomen and bowel sounds (Choice D) can be important but is not the initial priority when addressing the vomiting post hydromorphone administration.

4. A client is prescribed phenobarbital 100 mg daily for the treatment of seizures. Which statement made by the client indicates an accurate understanding of the medication phenobarbital?

• A. I will take my medicine at 10 PM before retiring to bed.
• B. The medication will turn the color of my urine to a pink color.
• C. I should not eat or drink anything for at least 2 hours before taking my medicine.
• D. In the event a seizure occurs in the middle of the day, I need to take an extra dose of my medicine.

Correct answer: A

Rationale: The correct answer is A. Phenobarbital should be taken at the same time every day to maintain blood levels and enhance compliance. Common side effects of phenobarbital include drowsiness, lethargy, dizziness, and nausea; therefore, it is best to take it before bedtime to minimize these effects and improve sleep quality. Choice B is incorrect because phenobarbital does not affect the color of urine. Choice C is incorrect because there is no need to fast before taking phenobarbital. Choice D is incorrect because taking extra doses without healthcare provider guidance can lead to overdose and adverse effects.

5. A client with diabetes mellitus type 2 is prescribed glipizide. 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 hypoglycemia to the healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client prescribed glipizide, a sulfonylurea used to lower blood sugar levels, is to take the medication with meals. Taking it with meals helps to minimize the risk of hypoglycemia by ensuring a more balanced effect on blood glucose levels throughout the day. It is important for the client to follow this instruction to maintain stable blood sugar levels and reduce the likelihood of experiencing low blood sugar (hypoglycemia) episodes. Choice B is incorrect because there are no specific contraindications between glipizide and alcohol. Choice C is incorrect as glipizide should not be taken on an empty stomach. Choice D is incorrect as while it is important to report signs of hypoglycemia, the primary focus should be on preventing hypoglycemia by taking the medication with meals.

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