Nursing Elites

1. A practical nurse (PN) is reviewing teaching with the client and/or significant others about the concurrent use of benztropine and olanzapine to manage psychotic behavior. What information should the PN reinforce?

• A. Benztropine will reduce olanzapine's side effect of urinary retention.
• B. Benztropine potentiates the effect of olanzapine.
• C. Benztropine is used to control the side effects of olanzapine.
• D. The combined effect of these drugs will modify psychotic behavior.

Correct answer: C

Rationale: The correct answer is C because benztropine, an anticholinergic drug, is used to control extrapyramidal symptoms associated with olanzapine use. Choice A is incorrect because benztropine does not directly reduce olanzapine's side effect of urinary retention. Choice B is incorrect as benztropine does not potentiate the effect of olanzapine; its main role is to counteract extrapyramidal symptoms. Choice D is incorrect because the primary purpose of using benztropine alongside olanzapine is to manage side effects, not specifically to modify psychotic behavior.

2. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?

• A. Take the medication at the same time every day.
• B. Discontinue the medication if a rash develops.
• C. Avoid consuming dairy products.
• D. Monitor blood pressure regularly.

Correct answer: A

Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.

3. How do you determine if the medication is effective for a client with anemia secondary to chronic kidney disease (CKD)?

• A. Food diary shows increased consumption of iron-rich foods
• B. Reports of increased energy levels and decreased fatigue
• C. Hemoglobin level increased to 12 grams/dL
• D. Takes concurrent iron therapy without adverse effects

Correct answer: C

Rationale: The correct answer is C. To assess the effectiveness of medication for anemia in a client with CKD, monitoring hemoglobin levels is crucial. Hemoglobin levels directly indicate the response to treatment and improvement in the condition. An increase in hemoglobin level to 12 grams/dL suggests that the medication is effectively addressing the anemia associated with CKD. Choices A, B, and D are incorrect because increased consumption of iron-rich foods, reports of increased energy levels and decreased fatigue, and tolerance to concurrent iron therapy without adverse effects are not direct indicators of the medication's effectiveness in treating anemia secondary to CKD.

4. What instruction should the nurse include in the teaching plan for a client prescribed ranitidine for a peptic ulcer?

• A. Take this medication in the morning before breakfast.
• B. Take this medication with meals.
• C. Avoid taking this medication with antacids.
• D. Take this medication at bedtime.

Correct answer: A

Rationale: The correct instruction for a client prescribed ranitidine for a peptic ulcer is to take the medication in the morning before breakfast. This timing helps reduce stomach acid production throughout the day, providing optimal therapeutic effects. Option B is incorrect because taking ranitidine with meals is not the recommended timing. Option C is incorrect as there is no specific contraindication against taking ranitidine with antacids. Option D is incorrect as the medication should not be taken at bedtime but rather in the morning before breakfast.

5. A client with diabetes mellitus type 2 is prescribed glipizide. What instruction should the nurse include in the client's teaching plan?

• A. Take this medication with meals.
• B. Avoid alcohol while taking this medication.
• C. Take this medication on an empty stomach.
• D. Report any signs of hypoglycemia to the healthcare provider.

Correct answer: A

Rationale: The correct instruction for a client prescribed glipizide, a sulfonylurea used to lower blood sugar levels, is to take the medication with meals. Taking it with meals helps to minimize the risk of hypoglycemia by ensuring a more balanced effect on blood glucose levels throughout the day. It is important for the client to follow this instruction to maintain stable blood sugar levels and reduce the likelihood of experiencing low blood sugar (hypoglycemia) episodes. Choice B is incorrect because there are no specific contraindications between glipizide and alcohol. Choice C is incorrect as glipizide should not be taken on an empty stomach. Choice D is incorrect as while it is important to report signs of hypoglycemia, the primary focus should be on preventing hypoglycemia by taking the medication with meals.

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