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. Which of the following is not an effect of the drug isoflurane?

• A. Elevated lipid levels
• B. Nausea
• C. Increased blood flow to the brain
• D. Decreased respiratory function

Correct answer: A

Rationale: Isoflurane is not known to cause elevated lipid levels. Common effects of isoflurane include nausea, increased blood flow to the brain, and decreased respiratory function. Elevated lipid levels are not typically associated with the administration of isoflurane, making choice A the correct answer.

3. A client who is withdrawing from alcohol has been prescribed Propranolol. Which information should the nurse include in the teaching?

• A. Increases the risk for seizure activity.
• B. Provides a form of aversion therapy.
• C. Decreases cravings.
• D. Results in mild hypertension.

Correct answer: C

Rationale: The correct information the nurse should include in the teaching is that Propranolol decreases cravings for alcohol. Propranolol is used as an adjunct medication during alcohol withdrawal to help reduce the desire for alcohol. Choice A is incorrect as Propranolol does not increase the risk for seizure activity; it can actually be used to prevent alcohol withdrawal seizures. Choice B is also incorrect as Propranolol does not provide aversion therapy. Choice D is incorrect as Propranolol is not known to result in mild hypertension.

4. A client is being taught about taking Tetracycline to treat a GI infection caused by Helicobacter pylori. Which of the following statements should indicate to the nurse that the client understands the instructions?

• A. I will take this medication with 8 ounces of milk.
• B. I will inform my doctor if I experience diarrhea.
• C. I can discontinue this medication when I feel completely well.
• D. I can take this medication just before bedtime.

Correct answer: B

Rationale: The correct answer is B. Diarrhea can indicate the development of a suprainfection, which can be serious. Therefore, it is essential for the client to notify the healthcare provider if they experience diarrhea while taking Tetracycline to treat a GI infection caused by Helicobacter pylori. Choices A, C, and D are incorrect because taking Tetracycline with milk can reduce its absorption, discontinuing the medication prematurely can lead to treatment failure, and taking it just before bedtime may increase the risk of esophageal irritation due to the potential reflux of the medication.

5. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?

• A. Excessive doxorubicin can result in myelosuppression.
• B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
• C. An excess amount of doxorubicin can lead to cardiomyopathy.
• D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.

Correct answer: C

Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.

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