Nursing Elites

1. A practical nurse (PN) is providing education to a client who is starting therapy with metformin for type 2 diabetes. What side effect should the client be instructed to report to the healthcare provider?

• A. Weight gain
• B. Hypoglycemia
• C. Muscle pain
• D. Nausea

Correct answer: D

Rationale: The correct answer is 'Nausea.' Nausea is a common side effect of metformin, especially when the medication is first started. It is essential for the client to report persistent or severe nausea to the healthcare provider for further evaluation and management. Weight gain (Choice A) is not a typical side effect of metformin; in fact, metformin is associated with weight loss or weight neutrality. Hypoglycemia (Choice B) is a potential side effect of some diabetes medications, but metformin does not typically cause hypoglycemia. Muscle pain (Choice C) is not a common side effect of metformin; it is more commonly associated with other medications like statins.

2. A client with a diagnosis of schizophrenia is prescribed olanzapine. The nurse should monitor for which potential side effect?

• A. Weight gain
• B. Insomnia
• C. Dry mouth
• D. Headache

Correct answer: A

Rationale: When a client with schizophrenia is prescribed olanzapine, the nurse should monitor for weight gain as a potential side effect. Olanzapine is known to cause metabolic changes that can lead to weight gain, making it crucial for the nurse to closely monitor the client's weight during treatment. This side effect is significant as it can impact the client's overall health and well-being, so early detection and intervention are essential to manage it effectively.

3. A practical nurse is reviewing the medication administration record for a client prescribed prednisone. What potential side effect should the nurse monitor for?

• A. Hypoglycemia
• B. Weight loss
• C. Hypertension
• D. Diarrhea

Correct answer: C

Rationale: Prednisone, a corticosteroid, can cause side effects such as hypertension, fluid retention, and weight gain. Hypertension is a common side effect of prednisone due to its impact on sodium and fluid retention in the body. Monitoring blood pressure is crucial to detect and manage hypertension in clients taking prednisone. Choices A, B, and D are incorrect. While prednisone can indirectly affect blood glucose levels, hypoglycemia is not a common side effect. Weight gain, not weight loss, is more prevalent with prednisone use. Diarrhea is not a typical side effect associated with prednisone.

4. A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines the client has been self-administering St. John's wort, an herbal preparation, on the advice of a friend. What information is most significant about this finding?

• A. Wort can decrease plasma concentration of Cyclospora
• B. Wort can decrease plasma concentration of Tacrolimus
• C. Wort can decrease plasma concentration of Cyclosporine
• D. Wort can decrease plasma concentration of Mycophenolate

Correct answer: C

Rationale: The most significant information about the client self-administering St. John's wort, an herbal preparation, is that it can decrease the plasma concentration of Cyclosporine. St. John's wort is known to reduce the efficacy of Cyclosporine, which is a common immunosuppressant drug used to prevent transplant rejection. Choices A, B, and D are incorrect because St. John's wort does not affect the plasma concentration of Cyclospora, Tacrolimus, or Mycophenolate.

5. A client with type 2 diabetes mellitus is prescribed semaglutide. The nurse should monitor for which potential adverse effect?

• A. Nausea
• B. Hypoglycemia
• C. Hyperglycemia
• D. Pancreatitis

Correct answer: A

Rationale: The correct answer is A: Nausea. Semaglutide, a medication used to treat type 2 diabetes, is known to cause nausea as a potential adverse effect. It is important for the nurse to monitor the client for gastrointestinal symptoms, including nausea, after initiating treatment with semaglutide. While hypoglycemia and hyperglycemia are common concerns in diabetes management, they are not the primary adverse effects associated with semaglutide. Pancreatitis is a serious but rare adverse effect of GLP-1 receptor agonists like semaglutide, which should also be monitored for, but nausea is a more common and immediate concern.

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