Nursing Elites

1. When planning to administer the antiulcer GI agent sucralfate, what instruction should the nurse provide regarding administration?

• A. Administer sucralfate once a day
• B. Assess for secondary candida infection
• C. Monitor electrolyte imbalance
• D. Give sucralfate on an empty stomach

Correct answer: D

Rationale: Sucralfate is most effective when taken on an empty stomach. This allows the medication to form a protective layer over the ulcer, promoting healing and symptom relief. Administering sucralfate with or after meals may reduce its efficacy as it may bind to food instead of coating the ulcer site.

2. A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse (PN) reinforce to this client?

• A. Maintain consistent sodium intake.
• B. Use sunscreen when outdoors.
• C. Return for monthly urinalysis.
• D. Brush and floss teeth daily.

Correct answer: D

Rationale: The correct answer is to reinforce the instruction to brush and floss teeth daily. Phenytoin therapy can lead to gingival hyperplasia (gum disease), which can be prevented by maintaining good oral hygiene practices such as brushing and flossing daily. Choices A, B, and C are incorrect because they are not directly related to the side effects or management of phenytoin therapy. Maintaining consistent sodium intake is not a specific concern with phenytoin. Using sunscreen when outdoors is important to prevent sunburn but is not directly related to phenytoin therapy. Returning for monthly urinalysis may be necessary for other medications, but it is not specifically required for monitoring phenytoin therapy.

3. A client with diabetes mellitus type 1 is prescribed insulin lispro. When should the nurse instruct the client to administer this medication?

• A. 5-10 minutes before meals
• B. 15 minutes after meals
• C. 30 minutes before meals
• D. 1 hour after meals

Correct answer: A

Rationale: Corrected Rationale: Insulin lispro is a rapid-acting insulin that should be administered 5-10 minutes before meals. This timing helps synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing postprandial hyperglycemia. Choice B, administering 15 minutes after meals, is incorrect because rapid-acting insulins like lispro are meant to act quickly to cover the rise in blood glucose levels after meals. Choices C and D are also incorrect as they do not align with the rapid onset of action required to manage postprandial hyperglycemia in patients with diabetes mellitus type 1.

4. A client is prescribed diazepam for muscle spasms. What instruction should the nurse include in the client's teaching plan?

• A. Avoid drinking alcohol
• B. Take with food to avoid gastrointestinal upset
• C. Increase fluid intake
• D. Take medication with grapefruit juice

Correct answer: A

Rationale: The correct instruction for a client prescribed diazepam for muscle spasms is to avoid drinking alcohol. Diazepam can cause drowsiness and enhance the effects of alcohol, leading to increased sedation and impaired cognitive function. Clients should be advised to avoid alcohol consumption while taking diazepam to prevent these adverse effects and ensure their safety.

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

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

Correct answer: A

Rationale: Exenatide, a medication commonly used in type 2 diabetes, is known to cause gastrointestinal side effects, such as nausea. Monitoring for nausea is essential as it can lead to decreased appetite and potential weight loss, affecting the nutritional status of the client. While hypoglycemia and hyperglycemia are important to monitor in diabetes management, they are not typically associated with exenatide use. Pancreatitis is a rare but serious adverse effect of exenatide, which requires immediate medical attention if suspected.

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