Nursing Elites

1. Which of the following types of insulin is classified as 'long-acting'?

• A. Lispro (Humalog)
• B. NPH (Humulin N)
• C. Regular insulin (Humulin R)
• D. Glargine (Lantus)

Correct answer: D

Rationale: The correct answer is Glargine (Lantus). Glargine is classified as a long-acting insulin due to its slow, steady release over an extended period, making it suitable for basal insulin requirements. It has a duration of action that can last up to 24 hours, helping to maintain stable blood sugar levels throughout the day. Lispro (Humalog) is a rapid-acting insulin, NPH (Humulin N) is an intermediate-acting insulin, and Regular insulin (Humulin R) is a short-acting insulin, so they are not classified as long-acting insulins.

2. A client has been prescribed Atorvastatin to lower cholesterol. Which of the following instructions should the nurse include?

• A. Take this medication with a full glass of water.
• B. Report any muscle pain to your provider immediately.
• C. Avoid drinking grapefruit juice while taking this medication.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: B

Rationale: The correct instruction for the nurse to include is to 'Report any muscle pain to your provider immediately.' Muscle pain can be a sign of rhabdomyolysis, a rare but serious side effect of statins like atorvastatin. It is crucial to monitor for potential complications, and reporting muscle pain promptly can lead to timely intervention if needed. Choices A, C, and D are incorrect because they do not address a critical side effect of atorvastatin or provide essential information for the client's safety and well-being.

3. A client with heart failure is being instructed on laxative use. Which of the following laxatives should the client avoid?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: The correct answer is A: Sodium phosphate. Clients with heart failure often follow a sodium-restricted diet. Sodium phosphate laxatives can lead to sodium absorption, causing fluid retention, which is contraindicated in heart failure. It is crucial to avoid sodium phosphate laxatives in these clients to prevent exacerbation of fluid overload and heart failure symptoms. Psyllium (choice B), Bisacodyl (choice C), and Polyethylene glycol (choice D) are not contraindicated in clients with heart failure and can be used safely for bowel management.

4. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

5. A client has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

• A. Increase intake of protein-rich foods.
• B. Expect muscle twitching to occur.
• C. Take this medication with food.
• D. Anticipate relief of manifestations in 24 hours.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to take Levodopa/Carbidopa with food. This recommendation helps reduce gastrointestinal side effects commonly associated with this medication. Food can help minimize nausea and other stomach-related issues that may occur when taking Levodopa/Carbidopa. Options A, B, and D are incorrect. Increasing intake of protein-rich foods is not necessary with this medication. Muscle twitching is not an expected side effect of Levodopa/Carbidopa. Anticipating relief of manifestations in 24 hours is unrealistic as it may take days to weeks for the full therapeutic effect of the medication to be achieved.

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