Nursing Elites

1. Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A healthcare provider reinforces instructions for the client and advises them to avoid which of the following while taking this medication?

• A. Alcohol
• B. Organ meats
• C. Whole-grain cereals
• D. Carbonated beverages

Correct answer: A

Rationale: Alcohol should be avoided when taking glimepiride (Amaryl) because it can cause a disulfiram-like reaction and enhance the hypoglycemic effects of the medication. Consuming alcohol with glimepiride can lead to symptoms such as flushing, palpitations, nausea, and vomiting. Therefore, it is crucial for individuals on glimepiride therapy to steer clear of alcohol to prevent adverse reactions and maintain optimal medication efficacy.

2. A client is learning how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?

• A. Withdraws the NPH insulin first
• B. Withdraws the regular insulin first
• C. Injects air into the NPH insulin vial first
• D. Injects an amount of air equal to the desired dose of insulin into the vial

Correct answer: A

Rationale: When mixing regular insulin with another insulin preparation, it is crucial to withdraw the regular insulin first to prevent contamination. NPH insulin should be drawn after the regular insulin to maintain the integrity of each insulin type. Therefore, if the client withdraws the NPH insulin first, it indicates the need for further teaching. Choice B is correct as withdrawing regular insulin first is the appropriate step. Choice C is incorrect as air should be injected into the vial containing the regular insulin to maintain pressure. Choice D is incorrect as injecting air equal to the desired dose of insulin into the vial is a correct step in preparing the insulin for withdrawal.

3. A client has just taken a dose of trimethobenzamide (Tigan). The nurse plans to monitor this client for relief of:

• A. Heartburn
• B. Constipation
• C. Abdominal pain
• D. Nausea and vomiting

Correct answer: D

Rationale: The correct answer is D: Nausea and vomiting. Trimethobenzamide (Tigan) is an antiemetic medication used to treat nausea and vomiting. Therefore, the nurse would monitor the client for relief of nausea and vomiting after taking this medication.

4. A client is being educated about the use of sertraline (Zoloft) for depression. Which statement by the client indicates a need for further teaching?

• A. I should take the medication with a high-protein meal.
• B. I may experience dizziness when getting up quickly.
• C. I might notice a decrease in my sex drive.
• D. I should report any thoughts of self-harm to my healthcare provider.

Correct answer: A

Rationale: The statement 'I should take the medication with a high-protein meal' indicates a need for further teaching as sertraline (Zoloft) should not be taken with a high-protein meal due to potential interference with medication absorption. Choices B, C, and D are correct statements associated with the use of sertraline for depression. It is common to experience dizziness when quickly getting up, notice a decrease in sex drive, and important to report any thoughts of self-harm to the healthcare provider while on this medication.

5. When a client taking warfarin sodium (Coumadin) is prescribed ciprofloxacin (Cipro), the nurse should closely monitor the client for which potential effect of this drug interaction?

• A. Increased risk of bleeding
• B. Decreased warfarin effectiveness
• C. Increased risk of thrombosis
• D. Decreased ciprofloxacin effectiveness

Correct answer: A

Rationale: When ciprofloxacin (Cipro) is given with warfarin sodium (Coumadin), it can potentiate the effects of warfarin, leading to an increased risk of bleeding. Therefore, the nurse should closely monitor the client's INR levels and watch for signs of bleeding such as bruising, petechiae, or black tarry stools.

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