Nursing Elites

1. A client with rheumatoid arthritis is prescribed leflunomide. What instruction should the nurse include in the client's teaching plan?

• A. Avoid alcohol while taking this medication.
• B. Take this medication with food to decrease gastrointestinal upset.
• C. Avoid sunlight while taking this medication.
• D. Report any signs of infection to the healthcare provider.

Correct answer: A

Rationale: Leflunomide can increase sensitivity to sunlight. While it is important to avoid excessive sun exposure, the critical instruction for the client is to avoid alcohol while taking this medication. Alcohol can potentiate the hepatotoxic effects of leflunomide, making it crucial for the client to abstain from alcohol consumption to prevent liver damage.

2. In the immediate postoperative period, a client is prescribed morphine via a patient-controlled analgesia (PCA) pump. Which finding should the PN consider the highest priority in this client?

• A. Monitoring the expiration date of the PCA morphine
• B. Assessing the rate and depth of the client's respirations
• C. Reviewing the type of anesthesia used during the surgery
• D. Observing the client's signs of disorientation

Correct answer: B

Rationale: The highest priority for the PN is to assess the rate and depth of the client's respirations when a client is receiving morphine via a PCA pump. Respiratory depression is a life-threatening side effect of intravenous morphine administration. If the client's respiratory rate falls below 10 breaths/min, the PCA pump should be stopped, and the healthcare provider must be notified immediately to prevent further complications. Monitoring the expiration date of the PCA morphine is important but not the highest priority compared to assessing respiratory status. Reviewing the type of anesthesia used during the surgery is not directly related to the immediate management of the client receiving morphine via PCA. Observing signs of disorientation is also important but not as critical as assessing respirations for potential respiratory depression.

3. A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed salmeterol. The nurse should monitor for which potential side effect?

• A. Dry mouth
• B. Tachycardia
• C. Insomnia
• D. Increased appetite

Correct answer: A

Rationale: The correct answer is dry mouth. Salmeterol, a long-acting beta agonist used in COPD, can lead to dry mouth as a common side effect. Nurses should monitor for this side effect and advise clients to report it if it becomes bothersome.

4. A client with a diagnosis of generalized anxiety disorder is prescribed hydroxyzine. 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. Hydroxyzine is known to cause drowsiness, so clients should be advised to avoid activities like driving until they understand how the medication affects them. Choices B, C, and D are incorrect because dry mouth, nausea, and headache are not commonly associated with hydroxyzine use. It is crucial for the client to be aware of the potential drowsiness to ensure their safety and well-being while taking this medication.

5. When should a glucagon emergency kit be used for a client with Type 1 diabetes?

• A. During episodes of hypoglycemia
• B. At the onset of signs of diabetic ketoacidosis
• C. Before meals to prevent hyperglycemia
• D. When signs of severe hypoglycemia occur

Correct answer: D

Rationale: A glucagon emergency kit is used when signs of severe hypoglycemia occur in a client with Type 1 diabetes. Glucagon helps raise blood glucose levels in cases of severe hypoglycemia when the individual is unable to take oral glucose. It is crucial to administer glucagon promptly to prevent serious complications associated with low blood sugar levels. Choices A, B, and C are incorrect because a glucagon emergency kit is specifically indicated for severe hypoglycemia, not for general episodes of hypoglycemia, diabetic ketoacidosis, or prevention of hyperglycemia.

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