Nursing Elites

1. A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?

• A. Relieve neuropathic pain
• B. Reduce inflammation
• C. Enhance opioid analgesia
• D. Suppress cough

Correct answer: A

Rationale: Gabapentin is primarily prescribed to relieve neuropathic pain. It works by stabilizing electrical activity in the nerves, making it effective in managing conditions such as diabetic neuropathy, postherpetic neuralgia, and other forms of chronic pain originating from nerve damage.

2. A client with type 2 diabetes mellitus is prescribed metformin (Glucophage). Which instruction should the nurse provide?

• A. Take the medication on an empty stomach.
• B. Limit your fluid intake while on this medication.
• C. Monitor your blood glucose levels regularly.
• D. Avoid eating foods high in potassium.

Correct answer: C

Rationale: Monitoring blood glucose levels regularly is crucial for clients with type 2 diabetes who are taking metformin. This helps assess the effectiveness of the medication in managing blood sugar levels and allows for timely adjustments in the treatment plan if needed. By monitoring blood glucose levels, the client and healthcare team can work together to achieve optimal diabetes control and prevent complications associated with uncontrolled blood sugar levels.

3. A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response?

• A. Administer a Fleet enema as prescribed and remain with the client
• B. Contact the primary care provider promptly and report these signs of perforation
• C. Position the client supine and insert an NG tube
• D. Page the primary provider and report that the client may be obstructed

Correct answer: B

Rationale: In a client with acute diverticulitis experiencing sudden increase in temperature, exquisite abdominal tenderness, and uncharacteristic abdominal rigidity, these signs suggest a possible perforation. The nurse should promptly contact the primary care provider to report these signs, as perforation requires immediate medical attention to prevent further complications.

4. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching?

• A. Avoid alcohol while taking this medication.
• B. Take the medication with a full meal.
• C. Increase your intake of high-fiber foods.
• D. Avoid exposure to sunlight.

Correct answer: A

Rationale: The correct instruction for the client prescribed with methotrexate is to avoid alcohol while taking this medication. Methotrexate can cause liver toxicity, and alcohol consumption can further exacerbate this risk. It is crucial for patients to abstain from alcohol to prevent adverse effects on the liver. Therefore, instructing the client to avoid alcohol is a key component of safe medication use and management of rheumatoid arthritis.

5. A patient is admitted with a diagnosis of myasthenia gravis. What symptom should the nurse expect to find during the assessment?

• A. Joint pain
• B. Muscle weakness
• C. Loss of sensation
• D. Severe headache

Correct answer: B

Rationale: Myasthenia gravis is a neuromuscular disorder characterized by muscle weakness and fatigue, especially in the voluntary muscles. Patients with myasthenia gravis commonly experience weakness in muscles that control eye movements, facial expressions, chewing, swallowing, and speaking. This weakness typically worsens with activity and improves with rest. Joint pain, loss of sensation, and severe headaches are not typical symptoms of myasthenia gravis. Therefore, the correct answer is muscle weakness (choice B) as it aligns with the characteristic symptom of myasthenia gravis.

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