Nursing Elites

1. The practical nurse administers lactulose to a client. Which client outcome would indicate a therapeutic response?

• A. An increase in urine output
• B. Two to three soft stools per day
• C. Absence of nausea
• D. Decreased serum potassium

Correct answer: B

Rationale: Lactulose is a type of laxative that works by preventing the absorption of ammonia in the colon, leading to increased water absorption in the stool and softening of the stool. The therapeutic response to lactulose is indicated by the passage of two to three soft stools per day, showing that the medication is effectively promoting bowel movements.

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

• A. Before meals
• B. After meals
• C. At bedtime
• D. In the morning

Correct answer: C

Rationale: Corrected Rationale: Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours. Administering it at bedtime helps mimic the body's natural insulin secretion pattern and provides optimal blood glucose control during the night and throughout the day. Choice A (Before meals) is incorrect because insulin glargine is not a rapid-acting insulin meant to cover meals. Choice B (After meals) is incorrect as the timing doesn't align with the insulin's mechanism. Choice D (In the morning) is incorrect as administering insulin glargine in the morning may not provide adequate coverage throughout the night and the following day.

3. A client is receiving metronidazole for Clostridium difficile pseudomembranous colitis. Which information should the nurse include in this client's medication teaching plan?

• A. Drink adequate water daily
• B. Take with food
• C. Avoid alcohol consumption
• D. Store medication in the refrigerator

Correct answer: C

Rationale: The correct information to include in the medication teaching plan for a client receiving metronidazole for Clostridium difficile pseudomembranous colitis is to avoid alcohol consumption. Metronidazole can cause a disulfiram-like reaction when combined with alcohol, leading to symptoms such as nausea, vomiting, flushing, and headache. Therefore, it is crucial for the client to abstain from alcohol while taking this medication to prevent adverse effects and ensure treatment effectiveness. Choices A, B, and D are incorrect. Drinking adequate water daily is a general health recommendation but not specific to metronidazole use. Taking with food is not necessary for metronidazole, and in fact, it is recommended to be taken on an empty stomach for better absorption. Storing the medication in the refrigerator is also incorrect, as metronidazole should be stored at room temperature.

4. A client with diabetes mellitus type 2 is prescribed linagliptin. Which instruction should the nurse include in the client's teaching plan?

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: When a client is prescribed linagliptin, it is crucial to educate them to report any signs of pancreatitis to their healthcare provider. Linagliptin can lead to pancreatitis, making it essential for clients to be vigilant for symptoms such as severe abdominal pain, nausea, and vomiting. Timely reporting of these symptoms can aid in early intervention and management of pancreatitis.

5. A client with chronic kidney disease is prescribed erythropoietin. The nurse should monitor for which potential adverse effect?

• A. Hypertension
• B. Hypotension
• C. Tachycardia
• D. Bradycardia

Correct answer: A

Rationale: Erythropoietin is a medication commonly used to stimulate red blood cell production in individuals with chronic kidney disease. One of the potential adverse effects of erythropoietin therapy is hypertension. The increased production of red blood cells can lead to elevated blood pressure levels. Therefore, monitoring for hypertension is essential to ensure the client's safety and well-being while on this medication. Choices B, C, and D are incorrect because hypotension, tachycardia, and bradycardia are not typically associated with erythropoietin therapy. Hypertension is the primary adverse effect to monitor in this case.

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