Nursing Elites

1. A healthcare provider is providing discharge instructions to a client who has a new prescription for metformin. Which of the following instructions should the healthcare provider include?

• A. Take this medication with meals.
• B. Avoid consuming alcohol while taking this medication.
• C. Take this medication at bedtime.
• D. Report any muscle pain to your healthcare provider.

Correct answer: B

Rationale: The correct answer is B: 'Avoid consuming alcohol while taking this medication.' Clients taking metformin should avoid alcohol as it increases the risk of lactic acidosis. Choice A is incorrect because metformin is usually taken with meals to reduce gastrointestinal side effects. Choice C is incorrect as metformin is typically taken with meals, not at bedtime. Choice D is incorrect because muscle pain is not a common side effect of metformin.

2. A nurse is preparing discharge information for a client who has type 2 diabetes mellitus. Which resource should the nurse provide?

• A. Personal blogs about managing diabetes medications.
• B. Food exchange lists for meal planning from the American Diabetes Association.
• C. Diabetes medication information from the Physicians' Desk Reference.
• D. Food label recommendations from the Institute of Medicine.

Correct answer: B

Rationale: The correct answer is B: Food exchange lists for meal planning from the American Diabetes Association. Food exchange lists provide structured meal planning for individuals with diabetes, helping them make healthier food choices and manage their condition effectively. Choice A is incorrect because personal blogs may not provide accurate and reliable information on managing diabetes and medications. Choice C is incorrect as diabetes medication information may not be directly related to meal planning and dietary management. Choice D is incorrect because food label recommendations from the Institute of Medicine may not specifically cater to the dietary needs and meal planning guidelines recommended for individuals with diabetes.

3. When caring for a client with a new prescription for enoxaparin for the prevention of DVT, what is an appropriate action by the nurse?

• A. Expel any air bubbles at the top of the prefilled syringe
• B. Massage the injection site to evenly distribute the medication
• C. Inject the medication into the lateral abdominal wall
• D. Administer an NSAID for injection site discomfort

Correct answer: C

Rationale: When administering enoxaparin for the prevention of DVT, the nurse should inject the medication into the lateral abdominal wall. This site is preferred for subcutaneous injections of enoxaparin to reduce the risk of bleeding or injury. Expelling air bubbles, massaging the injection site, or administering an NSAID for discomfort are not appropriate actions and could lead to complications or ineffective medication delivery.

4. A nurse is caring for a client who has chronic kidney disease and a serum potassium level of 6.5 mEq/L. Which of the following actions should the nurse take?

• A. Administer sodium bicarbonate
• B. Administer sodium polystyrene sulfonate
• C. Administer calcium gluconate
• D. Administer calcium carbonate

Correct answer: B

Rationale: The correct action for the nurse to take is to administer sodium polystyrene sulfonate. This medication promotes potassium excretion and helps lower serum potassium levels in clients with hyperkalemia, which is indicated by a high potassium level. Sodium bicarbonate (choice A) is not used to treat hyperkalemia. Calcium gluconate (choice C) and calcium carbonate (choice D) are used to manage hyperkalemia by stabilizing cell membranes but are not the initial treatment choice for lowering potassium levels.

5. A nurse is caring for a client who has a prescription for clozapine. Which of the following laboratory values should the nurse monitor?

• A. Monitor blood glucose levels
• B. Monitor WBC count
• C. Monitor platelet count
• D. Monitor hemoglobin levels

Correct answer: B

Rationale: The correct answer is to monitor the WBC count. Clozapine can cause agranulocytosis, a severe decrease in WBC count, which can increase the risk of infection. Monitoring the WBC count is essential to detect this potentially life-threatening condition early. Monitoring blood glucose levels (Choice A) is not directly related to clozapine use. Platelet count (Choice C) and hemoglobin levels (Choice D) are not typically affected by clozapine and are not the priority for monitoring in this case.

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