Nursing Elites

1. What are the actions of the drug metformin?

• A. Decreases hepatic glucose production and intestinal glucose absorption
• B. Increases sensitivity to insulin
• C. Short-term sedation
• D. Both A and B

Correct answer: D

Rationale: Metformin has dual actions by decreasing hepatic glucose production and intestinal glucose absorption, which helps in reducing blood glucose levels. Additionally, it increases sensitivity to insulin, aiding in its proper utilization within the body. Choice A is correct as metformin acts by decreasing hepatic glucose production and intestinal glucose absorption. Choice B is also correct as metformin increases sensitivity to insulin. Choice C, short-term sedation, is incorrect as metformin is not known for causing sedation. Therefore, the correct answer is D because metformin performs both of these actions.

2. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

3. A client is receiving chemotherapy and has a prescription for ondansetron IV for nausea and vomiting. The nurse should monitor the client for which of the following adverse effects?

• A. Hypotension
• B. Bradycardia
• C. Tremors
• D. Urinary retention

Correct answer: C

Rationale: The correct answer is C: Tremors. Ondansetron can cause tremors as an adverse effect. Monitoring for tremors is essential as it can indicate a potential adverse reaction to the medication. Hypotension (choice A) and bradycardia (choice B) are not commonly associated with ondansetron. Urinary retention (choice D) is also not a typical adverse effect of ondansetron, making choices A, B, and D incorrect in this scenario.

4. A client is prescribed Metformin. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. Blood glucose
• B. Creatine kinase
• C. Hemoglobin A1c
• D. Serum creatinine

Correct answer: D

Rationale: The correct answer is D: Serum creatinine. Metformin can potentially cause lactic acidosis, particularly in patients with impaired renal function. Monitoring serum creatinine levels is crucial to assess kidney function and detect any adverse effects of Metformin on renal health. Choices A, B, and C are incorrect as blood glucose, creatine kinase, and hemoglobin A1c levels are not directly monitored to assess for potential adverse effects of Metformin. Blood glucose monitoring is typically done to assess the efficacy of antidiabetic medications like Metformin, while creatine kinase levels are indicative of muscle damage and hemoglobin A1c reflects long-term blood sugar control.

5. A healthcare professional working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the healthcare professional's priority?

• A. Administer flumazenil.
• B. Identify the client's level of orientation.
• C. Infuse IV fluids.
• D. Prepare the client for gastric lavage.

Correct answer: B

Rationale: When managing a client with Benzodiazepine toxicity, the priority action for the healthcare professional is to assess the client. Identifying the client's level of orientation allows the healthcare professional to understand the client's cognitive status, which is crucial for further interventions and decision-making in the care plan. Administering flumazenil (Choice A) may precipitate withdrawal symptoms and should be done cautiously. Infusing IV fluids (Choice C) can be important but is not the priority over assessing the client. Gastric lavage (Choice D) is not typically recommended due to the risk of complications and its limited effectiveness in cases of Benzodiazepine overdose.

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