Nursing Elites

1. A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication with your first bite of food.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication with your first bite of food.' Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. By taking the medication with the first bite of food, the client can help minimize potential stomach upset and improve the drug's effectiveness. Choice B is incorrect because taking Metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect as there is no specific recommendation to take Metformin before bedtime. Choice D is incorrect because Metformin is typically taken daily, not every other day, as prescribed by the healthcare provider.

2. A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: To minimize the risk of catheter embolism, it is crucial to avoid reinserting the needle into an IV catheter. This practice can potentially sever the end of the catheter, leading to catheter embolism. Proper insertion techniques, securement, and avoiding unnecessary manipulations of the catheter can help prevent this serious complication.

3. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

• A. Increased renal secretion
• B. Increased medication-metabolizing enzymes
• C. Liver failure
• D. Peripheral vascular disease

Correct answer: C

Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.

4. Which of the following types of insulin is classified as 'long-acting'?

• A. Lispro (Humalog)
• B. NPH (Humulin N)
• C. Regular insulin (Humulin R)
• D. Glargine (Lantus)

Correct answer: D

Rationale: The correct answer is Glargine (Lantus). Glargine is classified as a long-acting insulin due to its slow, steady release over an extended period, making it suitable for basal insulin requirements. It has a duration of action that can last up to 24 hours, helping to maintain stable blood sugar levels throughout the day. Lispro (Humalog) is a rapid-acting insulin, NPH (Humulin N) is an intermediate-acting insulin, and Regular insulin (Humulin R) is a short-acting insulin, so they are not classified as long-acting insulins.

5. A client has a new prescription for Sulfasalazine for the treatment of Crohn's disease. Which of the following instructions should the nurse include?

• A. Expect orange-yellow discoloration of urine and skin.
• B. Take the medication with food.
• C. Do not discontinue the medication if a sore throat occurs.
• D. Avoid prolonged exposure to sunlight.

Correct answer: A

Rationale: The correct answer is A: 'Expect orange-yellow discoloration of urine and skin.' Sulfasalazine can cause this harmless side effect, which does not require discontinuation of the medication. Option B is incorrect because Sulfasalazine is usually taken with food to minimize gastrointestinal side effects. Option C is incorrect as a sore throat is not a common reason to stop the medication. Option D is not directly related to the side effects of Sulfasalazine.

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