Nursing Elites

1. A nurse is administering metformin to a client with type 2 diabetes. Which of the following adverse effects should the nurse monitor for in this client?

• A. Diarrhea
• B. Hyperglycemia
• C. Hypoglycemia
• D. Lactic acidosis

Correct answer: D

Rationale: The correct answer is D, Lactic acidosis. Lactic acidosis is a rare but serious adverse effect of metformin use. Metformin is not known to cause hyperglycemia or hypoglycemia. Diarrhea is a common gastrointestinal side effect of metformin but is not as serious as lactic acidosis, which requires immediate medical attention.

2. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: The correct answer is A: Asthma. Clients with asthma should avoid Beta2 Blockade agents like propranolol as they can lead to bronchoconstriction, potentially worsening asthma symptoms. Choice B, hypertension, is not a contraindication for propranolol; in fact, it is commonly prescribed for hypertension. Choice C, tachydysrhythmias, is often an indication for propranolol due to its antiarrhythmic properties. Choice D, urolithiasis, does not directly impact the use of propranolol.

3. A nurse is caring for a client prescribed digoxin. Which of the following should alert the nurse to possible digitalis toxicity?

• A. Anorexia and weakness
• B. Hyperactivity and hunger
• C. Tachycardia and increased urination
• D. Polyphagia and polydipsia

Correct answer: A

Rationale: The correct answer is A: Anorexia and weakness. These symptoms are early indicators of potential digitalis toxicity. Anorexia refers to a loss of appetite, which can be a sign of toxicity, and weakness can indicate an issue with digoxin. Choices B, C, and D are incorrect. Hyperactivity and hunger, tachycardia and increased urination, as well as polyphagia and polydipsia are not typically associated with digitalis toxicity.

4. A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?

• A. Calcium channel blockers
• B. Potassium-sparing diuretics
• C. Beta blockers
• D. Loop diuretics

Correct answer: D

Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.

5. A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication?

• A. Change positions slowly and lie down if dizziness occurs
• B. There is no need to avoid normal activities
• C. Avoid dairy products while taking this medication
• D. Do not eat green leafy vegetables

Correct answer: A

Rationale: Corrected Rationale: First-dose orthostatic hypotension can occur with doxazosin. The nurse should advise the client to change positions slowly and lie down if dizziness occurs. Choice B is incorrect because it does not address the potential side effect of dizziness. Choice C and D are also incorrect as there is no specific dietary restriction related to doxazosin mesylate.

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