Nursing Elites

1. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.

2. A client is being discharged with a new prescription for Fluoxetine for PTS. Which of the following statements should the nurse include in the teaching?

• A. You may experience a decreased desire for intimacy while taking this medication.
• B. You should take this medication in the morning to avoid sleep disturbances.
• C. To minimize urinary adverse effects, ensure you urinate before taking this medication.
• D. It is recommended to wear sunglasses outdoors due to the light sensitivity caused by this medication.

Correct answer: A

Rationale: The correct statement for the nurse to include in the teaching is that the client may experience a decreased desire for intimacy while taking Fluoxetine for PTS. This is important because Fluoxetine, an SSRI used to treat PTS, can lead to decreased libido as a potential adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with Fluoxetine and are not directly relevant to the medication's effects for this patient.

3. A client has a new prescription for Captopril. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor your blood pressure weekly.
• C. Notify your provider if you develop a persistent cough.
• D. Avoid using salt substitutes to prevent hyperkalemia.

Correct answer: C

Rationale: Clients prescribed with Captopril, an ACE inhibitor, are at risk of developing a persistent cough as a common adverse effect. It is essential for the client to inform their healthcare provider promptly if this side effect occurs to evaluate the need for a medication change or adjustment.

4. When teaching a client with cancer who has a prescription for methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Magnesium
• C. Vitamin D
• D. Iron

Correct answer: A

Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, so instructing the client to take folic acid helps reduce the risk of methotrexate toxicity by providing additional folic acid that the medication may deplete. Magnesium (choice B), Vitamin D (choice C), and Iron (choice D) are not the correct supplements to instruct the client to take with methotrexate.

5. A client has a new prescription for Propranolol. Which of the following findings should be identified as a contraindication to this medication?

• A. Asthma
• B. Diabetes mellitus
• C. Hypertension
• D. Glaucoma

Correct answer: A

Rationale: Corrected Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with asthma. Asthma is a contraindication due to the potential for worsening bronchoconstriction and exacerbating respiratory symptoms. Choice B, diabetes mellitus, is not a contraindication for Propranolol. Choice C, hypertension, is actually an indication for Propranolol as it is commonly used to treat hypertension. Choice D, glaucoma, is not a contraindication for Propranolol use.

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