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. Which of the following conditions are not treated with Barbiturates?

• A. Seizures
• B. Hypotension
• C. Insomnia
• D. Anxiety

Correct answer: B

Rationale: Hypotension is not treated with barbiturates. Barbiturates are primarily used for treating seizures, insomnia, and anxiety, but they are not indicated for the treatment of hypotension.

3. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots forming and leading to serious complications like pulmonary embolism. Clients with a history of deep-vein thrombosis are at a higher risk of recurrent thromboembolic events when taking tamoxifen, making it unsafe for such individuals. Choices B, C, and D are not contraindications for tamoxifen therapy, as migraine headaches, hypertension, and anemia do not directly interact with tamoxifen's mechanism of action or pose significant risks when used together.

4. A client has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. After more than 5 days of use, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion. This occurs due to prolonged vasoconstriction of nasal blood vessels, causing worsening nasal congestion. Sedation (choice A) is not a common adverse effect of phenylephrine nasal drops. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with this medication.

5. A client has a new prescription for Trimethoprim-sulfamethoxazole. Which of the following information should the nurse include?

• A. Take the medication on an empty stomach.
• B. Maintain a fluid restriction while taking it.
• C. Take it with food.
• D. Stop taking it when manifestations subside.

Correct answer: C

Rationale: The correct answer is C: 'Take it with food.' Trimethoprim-sulfamethoxazole can cause gastrointestinal upset, and taking it with food helps reduce the risk of stomach irritation. It should not be taken on an empty stomach. Maintaining good hydration is important to prevent kidney-related side effects, so maintaining a fluid restriction, as in choice B, is not appropriate. Additionally, stopping the medication when manifestations subside, as in choice D, is incorrect as antibiotics should be taken for the full prescribed course to ensure eradication of the infection and to prevent antibiotic resistance.

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