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A client prescribed glipizide asked why they had to take their insulin orally. How should the practical nurse respond?
- A. Glipizide is not an oral form of insulin and can be used only when some beta cell function is present.
- B. Glipizide is an oral form of insulin and is distributed, metabolized, and excreted in the same manner as insulin.
- C. Glipizide is an oral form of insulin and has the same actions and properties as intermediate insulin.
- D. Glipizide is not an oral form of insulin, but it is effective for those who are resistant to injectable insulins.
Correct Answer: A
Rationale: The practical nurse should explain to the client that glipizide is not an oral form of insulin but an oral hypoglycemic agent. Glipizide works by enhancing pancreatic production of insulin when some beta cell function is present. It is not a replacement for insulin but helps the body produce more insulin. Therefore, it can be used when there is still some beta cell function present, unlike insulin which is used when there is a deficiency of endogenous insulin production.
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The practical nurse is assigned a client on digoxin therapy. Which finding is likely to predispose this client to developing digoxin toxicity?
- A. Hyponatremia
- B. Hypernatremia
- C. Hyperkalemia
- D. Hypokalemia
Correct Answer: D
Rationale: Hypokalemia predisposes a client on digoxin to digoxin toxicity. Symptoms of digoxin toxicity include abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and atrioventricular (AV) dissociation. Therefore, assessment of serum potassium levels and prompt correction of hypokalemia are crucial interventions for clients taking digoxin.
A client with rheumatoid arthritis is prescribed leflunomide. What instruction should the nurse include in the client's teaching plan?
- A. Avoid alcohol while taking this medication.
- B. Take this medication with food to decrease gastrointestinal upset.
- C. Avoid sunlight while taking this medication.
- D. Report any signs of infection to the healthcare provider.
Correct Answer: A
Rationale: Leflunomide can increase sensitivity to sunlight. While it is important to avoid excessive sun exposure, the critical instruction for the client is to avoid alcohol while taking this medication. Alcohol can potentiate the hepatotoxic effects of leflunomide, making it crucial for the client to abstain from alcohol consumption to prevent liver damage.
A client with a productive cough and fever has been diagnosed with bacterial pneumonia and is being admitted to the unit from the emergency room. Which intervention should the practical nurse ensure has been done prior to the administration of antibiotics?
- A. Sputum specimen
- B. Set of vital signs
- C. Electrocardiogram
- D. Glucometer check
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should monitor for which potential adverse effect?
- A. Pancreatitis
- B. Hypoglycemia
- C. Hyperglycemia
- D. Nausea
Correct Answer: A
Rationale: Corrected Rationale: Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor used in type 2 diabetes, has been associated with rare cases of pancreatitis. Therefore, the nurse should monitor for signs and symptoms of pancreatitis such as severe abdominal pain, nausea, and vomiting. While hypoglycemia is a potential adverse effect of some diabetes medications, it is less common with sitagliptin. Hyperglycemia is the condition being treated and is not an expected adverse effect of sitagliptin.
A client with a history of stroke is prescribed clopidogrel. The nurse should monitor for which potential side effect?
- A. Bleeding
- B. Weight gain
- C. Nausea
- D. Headache
Correct Answer: A
Rationale: When a client with a history of stroke is prescribed clopidogrel, the nurse should monitor for potential side effects, especially bleeding. Clopidogrel is an antiplatelet medication that works by preventing blood clots. One of the major risks associated with clopidogrel is an increased tendency to bleed. Therefore, monitoring for signs of bleeding, such as easy bruising, blood in stool or urine, or prolonged bleeding from minor cuts, is crucial to ensure patient safety and early intervention if needed.