Nursing Elites

1. A client has a new prescription for Metronidazole. Which of the following instructions should be included?

• A. Avoid drinking alcohol while taking this medication.
• B. Take the medication on an empty stomach.
• C. Increase your intake of green, leafy vegetables.
• D. Discontinue the medication if you experience a metallic taste.

Correct answer: A

Rationale: The correct instruction for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, resulting in severe nausea, vomiting, and other adverse effects. Therefore, it is crucial for clients to refrain from consuming alcohol during treatment to prevent these potential complications. Choice B is incorrect because Metronidazole can be taken with or without food. Choice C is irrelevant as there is no specific requirement to increase green, leafy vegetable intake with Metronidazole. Choice D is incorrect as a metallic taste is a known side effect of Metronidazole but does not necessarily indicate the need to discontinue the medication.

2. A client is starting therapy with filgrastim. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bone pain
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: When a client is starting therapy with filgrastim, monitoring for bone pain is essential. Filgrastim can lead to increased bone marrow activity, resulting in bone pain as a common adverse effect. Instructing the client to monitor and report any bone pain promptly can help in managing this side effect effectively.

3. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

4. A healthcare professional is caring for four clients who have Peptic Ulcer Disease. The healthcare professional should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor and potentially lead to harm to the fetus. Therefore, it should not be used in pregnant clients due to its uterotonic effects. For clients with osteoarthritis, kidney stone, or urinary tract infection, Misoprostol is not contraindicated specifically for these conditions.

5. A client in a substance abuse clinic is being assessed by a nurse after discontinuing disulfiram due to severe nausea and vomiting. What is the likely cause of the client's distress?

• A. The client demonstrated an allergic response to the medication.
• B. The client experienced a common side effect of the medication.
• C. The client consumed alcohol while taking the medication.
• D. The client took an overdose of the medication.

Correct answer: C

Rationale: Disulfiram, when combined with alcohol, leads to a severe reaction causing nausea and vomiting. Since the client experienced these symptoms after starting disulfiram, it is likely that they consumed alcohol while taking the medication. Choice A is incorrect because the symptoms are more indicative of the interaction with alcohol rather than an allergic response. Choice B is incorrect as severe nausea and vomiting are not common side effects of disulfiram alone. Choice D is incorrect as there is no indication of an overdose based on the symptoms described.

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