Nursing Elites

1. A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included in the teaching?

• A. Take the medication with a full glass of water after rising in the morning.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication with a meal to reduce gastric irritation.
• D. Crush the tablet and mix it with applesauce if difficulty swallowing.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water after rising in the morning to prevent esophageal irritation. It is important to remain upright for at least 30 minutes after taking the medication to reduce the risk of esophageal irritation and ensure proper absorption. Taking the medication with a meal or crushing the tablet are not recommended instructions for alendronate administration. Choice A is the correct answer as it aligns with the proper administration guidelines for alendronate.

2. Which of the following drugs is associated with extreme photosensitivity as a reaction?

• A. Digitalis
• B. Niacin
• C. Tetracycline
• D. Fluoroquinolones

Correct answer: C

Rationale: Tetracycline is known to cause extreme photosensitivity reactions, making individuals more sensitive to sunlight and increasing the risk of severe sunburn. It is essential for patients taking tetracycline to protect themselves from excessive sun exposure to prevent adverse reactions.

3. When reviewing facility policies for IV therapy with the team, a nurse manager should remind the team that which technique 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: Avoiding reinserting the needle into an IV catheter is crucial to minimizing the risk of catheter embolism. Reinserting the needle can lead to the severing of the catheter's end, potentially causing a catheter embolism, a serious complication. The other options, while important for IV therapy safety, are not directly related to preventing catheter embolism.

4. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

5. A healthcare professional is reviewing the medical history of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following findings should the healthcare professional report to the provider?

• A. Hemoglobin A1C of 7.5%
• B. Creatinine level of 1.2 mg/dL
• C. BUN level of 18 mg/dL
• D. Liver function tests showing AST of 50 units/L

Correct answer: D

Rationale: The correct answer is D. Elevated AST levels in liver function tests should be reported to the provider when a client is prescribed Metformin due to the potential risk of hepatotoxicity associated with the medication. Elevated Hemoglobin A1C (choice A), Creatinine level within normal range (choice B), and BUN level within normal range (choice C) are not directly concerning when initiating Metformin therapy.

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