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 assessing a client who is receiving morphine via a patient-controlled analgesia (PCA) pump. The nurse should identify that which of the following findings is a manifestation of opioid toxicity?

• A. Bradypnea.
• B. Tachycardia.
• C. Hypertension.
• D. Diaphoresis.

Correct answer: A

Rationale: Corrected Rationale: Bradypnea, or slow breathing, is a common sign of opioid toxicity. When a client is experiencing opioid toxicity, the respiratory system is usually the most affected, leading to a decrease in the respiratory rate (bradypnea). Tachycardia (increased heart rate), hypertension (high blood pressure), and diaphoresis (excessive sweating) are not typical manifestations of opioid toxicity. Therefore, the correct answer is bradypnea.

3. Which electrolyte imbalance is most concerning for a patient on furosemide?

• A. Hypokalemia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss through increased urinary excretion, making hypokalemia the most concerning electrolyte imbalance. Hyponatremia (Choice B) is not typically associated with furosemide use. Hyperkalemia (Choice C) is less likely due to furosemide's potassium-wasting effect. Hypercalcemia (Choice D) is not a common electrolyte imbalance seen with furosemide.

4. A nurse in a pediatric clinic is reviewing the laboratory test results of a school-age child. Which of the following findings should the nurse report to the provider?

• A. Hgb 12.5 g/dL.
• B. Platelets 250,000/mm³.
• C. Hct 40%.
• D. WBC 14,000/mm³.

Correct answer: D

Rationale: The correct answer is D. A WBC count of 14,000/mm³ is elevated, indicating a potential infection or inflammation, and should be reported to the provider for further evaluation and management. Choices A, B, and C are within normal ranges and do not require immediate reporting as they indicate normal hemoglobin, platelet count, and hematocrit levels for a school-age child.

5. A nurse is providing dietary teaching to a client with irritable bowel syndrome (IBS). What recommendation should be included?

• A. Consume foods high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase intake of foods high in gluten.

Correct answer: A

Rationale: The correct answer is A: Consume foods high in bran fiber. Bran fiber is recommended for clients with IBS as it promotes regularity and helps reduce symptoms. Choices B, C, and D are incorrect. Increasing milk products may exacerbate symptoms in some individuals with IBS due to lactose intolerance. Sweetening foods with fructose corn syrup can worsen symptoms as it is a type of sugar that can lead to gastrointestinal discomfort. Increasing intake of foods high in gluten is not recommended for individuals with IBS, especially those with gluten sensitivity, as it may trigger or worsen symptoms.

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