Nursing Elites

1. A client is taking metformin for type 2 diabetes. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Increased urine output
• B. Decreased fasting blood glucose
• C. Decreased hemoglobin A1C
• D. Decreased polyuria

Correct answer: C

Rationale: A decrease in hemoglobin A1C is a more specific indicator of metformin's effectiveness in controlling blood glucose levels over a longer period compared to fasting blood glucose levels. Hemoglobin A1C reflects average blood sugar levels over the past 2-3 months, providing a more comprehensive view of glycemic control. Increased urine output (choice A) is not a direct indicator of metformin's effectiveness and can be influenced by various factors. Decreased fasting blood glucose (choice B) can fluctuate due to various reasons and may not provide a reliable long-term assessment of metformin's efficacy. Decreased polyuria (choice D) refers to a symptom rather than a direct measure of metformin's effectiveness in managing diabetes.

2. An older adult client has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?

• A. Phenytoin
• B. Verapamil
• C. Warfarin
• D. Aluminum hydroxide

Correct answer: B

Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias. The other choices, Phenytoin, Warfarin, and Aluminum hydroxide, do not significantly interact with Digoxin to cause toxicity. Phenytoin may reduce Digoxin levels, while Warfarin and Aluminum hydroxide have minimal interactions with Digoxin.

3. What nursing interventions should you perform when a patient is on Albuterol? (Select all that apply)

• A. Assess lung sounds, pulse, and blood pressure before administering
• B. Monitor for changes in behavior
• C. Observe for paradoxical bronchospasms
• D. Both A and C

Correct answer: D

Rationale: The correct nursing interventions to perform when a patient is on Albuterol include assessing the patient's lung sounds, pulse, and blood pressure before administering the medication to monitor for cardiovascular side effects like increased heart rate. Additionally, it is crucial to observe for paradoxical bronchospasms, a rare but serious adverse reaction where the medication causes a worsening of bronchospasm instead of relief. Monitoring for changes in behavior is not directly related to Albuterol administration and is not a standard nursing intervention for patients receiving this medication, making choice B incorrect. Therefore, the correct answer is D as it includes the essential nursing actions for patients on Albuterol.

4. A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Limit your sodium intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client taking Metoprolol, a medication used to treat hypertension, is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down to standing up, leading to dizziness and falls. By advising the client to change positions slowly, the nurse helps prevent these adverse effects and promotes safety.

5. When a client has a new prescription for Dextromethorphan to suppress a cough, what adverse effect should they monitor for according to the nurse's instruction?

• A. Diarrhea
• B. Anxiety
• C. Sedation
• D. Palpitations

Correct answer: C

Rationale: The correct answer is C: Sedation. Dextromethorphan can lead to sedation as an adverse effect. The nurse should advise the client to avoid activities that require alertness when taking this medication to prevent any potential harm. Monitoring for sedation is crucial to ensure the client's safety and well-being. Choices A, B, and D are incorrect as diarrhea, anxiety, and palpitations are not commonly associated with Dextromethorphan use. While some individuals may experience gastrointestinal upset, central nervous system effects like sedation are more commonly observed.

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