Nursing Elites

1. What is a chemical reaction between drugs before their administration or absorption known as?

• A. a drug incompatibility
• B. a side effect
• C. an adverse event
• D. an allergic response

Correct answer: A

Rationale: A chemical reaction between drugs before their administration or absorption is termed a drug incompatibility. This phenomenon commonly happens when drug solutions are mixed before intravenous administration, but it can also occur with orally administered drugs. Choices B, C, and D are incorrect because side effects, adverse events, and allergic responses occur after the administration and absorption of drugs, not prior to it.

2. When treating anemia in clients with renal failure, erythropoietin should be given in conjunction with:

• A. iron, folic acid, and B12.
• B. an increase in protein in the diet.
• C. vitamins A and C.
• D. an increase in calcium in the diet.

Correct answer: A

Rationale: Erythropoietin is used to stimulate red blood cell production in clients with renal failure. To effectively increase red blood cell production, adequate levels of iron, folic acid, and B12 are necessary. These nutrients play crucial roles in erythropoiesis. Choices B, an increase in protein in the diet, is not directly related to enhanced erythropoiesis and can potentially worsen uremia. Choices C and D, vitamins A and C, and an increase in calcium in the diet, are not directly involved in red blood cell production and are not essential in this context.

3. Which instruction should be given in a health education class regarding testicular cancer?

• A. All males should perform a testicular exam after a warm bath or shower.
• B. Testicular exams should be performed on a daily basis.
• C. Reddening or darkening of the scrotum is a normal finding.
• D. Testicular exams should be performed after a warm bath or shower.

Correct answer: D

Rationale: The correct instruction for testicular cancer education is that testicular exams should be performed after a warm bath or shower as it relaxes the scrotum and makes the exam easier. Testicular exams should be done monthly by all men starting around age 15, not after the age of 30 (Choice A) or on a daily basis (Choice B), which is unnecessary and may lead to unnecessary anxiety. Reddening or darkening of the scrotum is not a normal finding (Choice C) and should be reported to a healthcare provider for further evaluation.

4. Why is it often necessary to draw a complete blood count and differential (CBC/differential) when a client is being treated with an antiepileptic drug (AED)?

• A. The hematocrit is adversely affected due to increased vascular volume.
• B. AEDs can lead to blood dyscrasia as a side effect.
• C. AEDs may cause aplastic anemia and megaloblastic anemia.
• D. Some AEDs induce white blood cell reduction.

Correct answer: B

Rationale: When a client is being treated with antiepileptic drugs (AEDs), it is essential to monitor for potential side effects on blood parameters. Some AEDs can lead to blood dyscrasia, which includes conditions like aplastic anemia and megaloblastic anemia. Therefore, drawing a complete blood count and differential helps in identifying these adverse effects early. Choices A, C, and D are incorrect because the primary concern when monitoring blood parameters in clients on AEDs is the risk of blood dyscrasia, not changes in hematocrit due to vascular volume, white blood cell reduction, or immune modulation.

5. The physician wants to know if a client is tolerating their total parenteral nutrition. Which of the following laboratory tests is likely to be ordered?

• A. triglyceride level
• B. liver function tests
• C. a glucose tolerance test
• D. a complete blood count

Correct answer: B

Rationale: The liver is crucial in processing nutrients and medications received through total parenteral nutrition. Liver function tests assess various enzymes produced by the liver, including prothrombin time/partial prothrombin time, serum glutamic oxaloacetic and pyruvic transaminases, gamma glutamyl transpeptidase, albumin, and alkaline phosphatase. Monitoring these enzymes can help determine if the liver is functioning properly to metabolize the nutrients from TPN. Triglyceride levels (Choice A) primarily evaluate the body's ability to clear fats, not specifically related to TPN tolerance. A glucose tolerance test (Choice C) is used to diagnose diabetes by measuring blood glucose levels after ingesting a glucose-rich solution, not directly related to TPN tolerance. A complete blood count (Choice D) assesses blood components such as red blood cells, white blood cells, and platelets but does not provide specific information about TPN tolerance.

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