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 healthcare professional is preparing to administer verapamil by IV bolus to a client who is experiencing cardiac dysrhythmias. For which of the following adverse effects should the healthcare professional monitor when giving this medication?

• A. Hyperthermia
• B. Hypotension
• C. Ototoxicity
• D. Muscle pain

Correct answer: B

Rationale: Verapamil is known to cause hypotension as one of its adverse effects due to its vasodilatory properties. Therefore, it is essential for the healthcare professional to monitor the client's blood pressure closely during and after administration to prevent complications such as severe hypotension. Hyperthermia, ototoxicity, and muscle pain are not commonly associated with verapamil administration, making choices A, C, and D incorrect.

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

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin sublingual tablets involves taking one tablet at the onset of chest pain and repeating every 5 minutes for up to three doses. This protocol helps in managing angina episodes effectively. Choice A suggests taking a tablet every 15 minutes until pain relief, which may delay appropriate intervention. Choice C, taking a tablet at bedtime, is not suitable for immediate relief during angina attacks. Choice D, taking a tablet on an empty stomach, is unrelated to the correct administration of Nitroglycerin sublingual tablets.

4. What finding should a nurse monitor for as an adverse effect when a client has a new prescription for Spironolactone?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: The correct answer is hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an increase in potassium levels. Hyperkalemia can be dangerous, causing muscle weakness and cardiac dysrhythmias. Monitoring potassium levels closely is crucial when a client is on Spironolactone. Hypoglycemia (choice B) is incorrect because Spironolactone does not typically affect blood glucose levels. Hypocalcemia (choice C) and hyponatremia (choice D) are also incorrect as Spironolactone's primary impact is on potassium levels.

5. A healthcare provider is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare provider to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction. Choices A, C, and D are important aspects of transfusion safety but are not directly related to preventing acute hemolytic reactions. Ensuring a patent IV line, monitoring vital signs, and staying with the client are all essential during transfusion but do not specifically address the risk of ABO or Rh incompatibility reactions.

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