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 with a new prescription for an antihypertensive medication is being provided discharge instructions by a nurse. Which of the following statements should the nurse give?

• A. Be sure to limit your potassium intake while taking the medication.
• B. You should check your blood pressure every 8 hours while taking this medication.
• C. Your medication dosage will be increased if you develop tachycardia.
• D. Change positions slowly when you move from sitting to standing.

Correct answer: D

Rationale: The correct statement for the nurse to provide is to instruct the client to change positions slowly when moving from sitting to standing. This is crucial because antihypertensive medications can cause orthostatic hypotension, leading to dizziness or lightheadedness when changing positions quickly. Checking blood pressure every 8 hours is unnecessary and could lead to over-monitoring. There is no direct relationship between the medication and potassium intake. Increasing the medication dosage due to tachycardia is not a typical response and may not be accurate.

3. A client is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion?

• A. I signed up for a swimming class.
• B. I've been taking an antacid to help with indigestion.
• C. I've lost 2 pounds since my appointment 2 weeks ago.
• D. The naproxen is easier to take when I crush it and put it in applesauce.

Correct answer: B

Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion. This statement suggests potential gastrointestinal distress or interactions between the medications. Antacids can affect the absorption of naproxen or lead to other complications. Therefore, the nurse should address this statement with the client to ensure safe and effective medication management. Choices A, C, and D do not raise immediate concerns related to the client's medication regimen and can be considered positive health behaviors or side effects of treatment that do not require immediate intervention.

4. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

• A. Reduced cardiac function
• B. First-pass effect
• C. Reduced hepatic function
• D. Increased gastric motility

Correct answer: C

Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.

5. A client is receiving treatment with capecitabine. Which of the following findings should the nurse monitor?

• A. Hyperglycemia
• B. Hypocalcemia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Capecitabine is known to cause neutropenia as a common adverse effect due to bone marrow suppression. Neutropenia increases the risk of infections and requires close monitoring to prevent complications. Hyperglycemia (Choice A) is not typically associated with capecitabine. Hypocalcemia (Choice B) and Bradycardia (Choice D) are not commonly linked to capecitabine use, making them incorrect choices.

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