Nursing Elites

1. Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauleen would be aware of the client's need for additional teaching when the client states:

• A. If I have hypoglycemia, I should eat some sugar, not dextrose.
• B. The drug makes my pancreas release more insulin.
• C. I should never take insulin while I'm taking this drug.
• D. It's best if I take the drug with the first bite of a meal.

Correct answer: B

Rationale: The correct answer is B. Acarbose (Precose) is an alpha-glucosidase inhibitor that works by slowing carbohydrate absorption in the intestine, not by stimulating insulin release. Therefore, the client would need additional teaching if they state that the drug makes their pancreas release more insulin (Choice B). Choices A, C, and D are incorrect. Choice A is incorrect because during hypoglycemia, it is recommended to consume glucose or dextrose to rapidly raise blood sugar levels. Choice C is incorrect because insulin therapy may still be needed in some cases, even when taking acarbose. Choice D is incorrect because acarbose should be taken at the start of a meal to help reduce postprandial blood glucose levels.

2. Why is glucose an important molecule in a cell?

• A. Extraction of energy
• B. Synthesis of protein
• C. Building of genetic material
• D. Formation of cell membranes

Correct answer: A

Rationale: Glucose is a crucial molecule in cells because it serves as the primary source of energy through cellular respiration. Choice B, the synthesis of protein, is incorrect because proteins are typically synthesized from amino acids, not glucose. Choice C, the building of genetic material, is incorrect because genetic material, such as DNA and RNA, is not directly built from glucose. Choice D, the formation of cell membranes, is also incorrect as cell membranes are primarily composed of lipids and proteins, not glucose.

3. The client with hyperthyroidism is receiving propylthiouracil (PTU). The nurse should monitor for which of the following potential side effects?

• A. Leukopenia
• B. Hyperglycemia
• C. Hypertension
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Leukopenia. Propylthiouracil can lead to bone marrow suppression, resulting in leukopenia. Monitoring white blood cell counts is crucial to detect this potential side effect early. Choice B, hyperglycemia, is not typically associated with propylthiouracil use. Choice C, hypertension, is not a common side effect of propylthiouracil. Choice D, weight gain, is also not a typical side effect of propylthiouracil therapy.

4. The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse expect to note in this client if excess fluid volume is present?

• A. Weight loss
• B. Flat neck and hand veins
• C. An increase in blood pressure
• D. A decreased central venous pressure (CVP)

Correct answer: C

Rationale: An increase in blood pressure is a common sign of fluid volume excess in clients with congestive heart failure due to the increased amount of fluid in the vascular system. Weight loss (Choice A) is not typically associated with fluid volume excess. Flat neck and hand veins (Choice B) are signs of fluid volume deficit, not excess. A decreased central venous pressure (CVP) (Choice D) is not expected in a client with fluid volume excess.

5. The client has been diagnosed with primary aldosteronism. Which of the following clinical findings would the nurse expect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: B

Rationale: Primary aldosteronism involves the overproduction of aldosterone by the adrenal glands. Aldosterone increases potassium excretion, leading to hypokalemia. Therefore, in primary aldosteronism, the nurse would expect to find hypokalemia, not hyperkalemia (choice A), hyponatremia (choice C), or hypercalcemia (choice D).

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