Nursing Elites

1. A nurse is caring for a client with a prescription for ferrous sulfate. What instruction should the nurse provide?

• A. Avoid strawberries and citrus fruits
• B. Take with fluids other than coffee or tea
• C. Take on a full stomach
• D. Double the dose if you miss a dose

Correct answer: B

Rationale: The correct instruction for a client prescribed ferrous sulfate is to take it with fluids other than coffee or tea. Coffee and tea can hinder iron absorption, so it's important to take the medication with other types of fluids. Choice A is incorrect because strawberries and citrus fruits are sources of vitamin C, which actually enhance iron absorption. Choice C is incorrect because ferrous sulfate is usually recommended to be taken on an empty stomach for better absorption. Choice D is incorrect as doubling the dose of ferrous sulfate can lead to an overdose and severe side effects.

2. A client with staphylococcus epidermidis is prescribed vancomycin. Identify the adverse effect associated with this antibiotic therapy.

• A. Hepatotoxicity
• B. Constipation
• C. Infusion reaction
• D. Immunosuppression

Correct answer: C

Rationale: The correct adverse effect associated with vancomycin therapy is an infusion reaction, known as Red Man Syndrome. This reaction presents with rashes, flushing, tachycardia, and hypotension. It is essential to administer vancomycin over at least 60 minutes to prevent these symptoms. Hepatotoxicity, constipation, and immunosuppression are not commonly associated with vancomycin use. Ototoxicity and renal toxicity are significant risks with prolonged vancomycin therapy.

3. A client with type 1 DM is being taught about hypoglycemia by a nurse. Which statement by the client indicates an understanding of the teaching?

• A. “Exercise decreases the risk of hypoglycemia.”
• B. “I should skip my insulin if I don't eat.”
• C. “I can drink 4 oz of regular soda if my blood sugar is low.”
• D. “Oral diabetic medications do not lead to hypoglycemia; only insulin does.”

Correct answer: C

Rationale: The correct answer is C because the client should have a quick-acting source of 15 g of carbohydrates to treat hypoglycemic episodes, such as 4 oz of regular soda. Choice A is incorrect because while exercise can help manage blood sugar levels, it can also increase the risk of hypoglycemia if not properly managed. Choice B is incorrect as skipping insulin when not eating can lead to hyperglycemia, not prevent hypoglycemia. Choice D is incorrect because certain oral diabetic medications can indeed cause hypoglycemia, not just insulin.

4. A healthcare provider is assessing a client who is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

• A. Hypoglycemia
• B. Proteinuria
• C. Nasal congestion
• D. Visual disturbances

Correct answer: B

Rationale: Corrected Rationale: Gentamicin is known to cause nephrotoxicity as an adverse effect. Proteinuria, which is the presence of excess proteins in the urine, may indicate kidney damage from the medication. Monitoring renal function is crucial in clients receiving gentamicin. Choice A, hypoglycemia, is not a typical adverse effect of gentamicin. Choices C and D, nasal congestion and visual disturbances, are not commonly associated with gentamicin use or its adverse effects.

5. A nurse is assessing a client who was brought to the psychiatric emergency services by law enforcement. The client has disorganized, incoherent speech with loose associations and religious content. The nurse should recognize these signs and symptoms as consistent with which of the following?

• A. Alzheimer's disease
• B. Schizophrenia
• C. Substance intoxication
• D. Depression

Correct answer: B

Rationale: The correct answer is B: Schizophrenia. Disorganized speech, loose associations, and religious delusions are characteristic symptoms of schizophrenia. In this scenario, the client's presentation aligns with positive symptoms of schizophrenia, indicating a severe mental disorder requiring immediate attention. Choice A, Alzheimer's disease, primarily involves cognitive decline and memory impairment, not disorganized speech or religious content. Choice C, Substance intoxication, may present with altered mental status but typically lacks the persistent pattern of symptoms seen in schizophrenia. Choice D, Depression, is associated with a different set of symptoms such as low mood, anhedonia, and changes in appetite or sleep, rather than disorganized speech and loose associations.

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