Nursing Elites

1. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

2. A client has been prescribed Prednisone for an inflammatory condition and is receiving discharge teaching from a nurse. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. Avoid alcohol while taking this medication.
• C. Monitor your blood pressure regularly.
• D. Take this medication in the morning to prevent insomnia.

Correct answer: D

Rationale: The correct answer is to take Prednisone in the morning to prevent insomnia. Prednisone can cause insomnia as a side effect, so taking it in the morning can help minimize this issue. It is important to follow the healthcare provider's instructions regarding the timing of Prednisone administration to optimize its effectiveness and minimize adverse effects.

3. 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.

4. A healthcare professional is preparing to administer Pamidronate to a client who has bone pain related to cancer. Which of the following precautions should the healthcare professional take when administering pamidronate?

• A. Inspect the IV site for redness and irritation when changing the intravenous patch.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to sit upright or stand for 30 min following intravenous administration.
• D. Watch for manifestations of anaphylaxis for 20 min after intramuscular administration.

Correct answer: B

Rationale: Pamidronate is administered through intravenous (IV) infusion. As this medication can be irritating to veins, the healthcare professional should carefully assess the IV site for thrombophlebitis during administration to prevent potential complications. Choice A is incorrect as Pamidronate is not administered via intradermal patch. Choice C is incorrect as it does not relate to the administration of Pamidronate. Choice D is incorrect as Pamidronate is not administered intramuscularly.

5. When teaching the family of a child with Cystic Fibrosis about a new prescription for Acetylcysteine, which information should the nurse include?

• A. Expect this medication to suppress your cough.
• B. Expect this medication to smell like rotten eggs.
• C. Expect this medication to cause euphoria.
• D. Expect this medication to turn your urine orange.

Correct answer: B

Rationale: The correct answer is B: 'Expect this medication to smell like rotten eggs.' Acetylcysteine contains sulfur, which gives it a characteristic rotten-egg odor. This odor is normal and expected when using this medication. Choices A, C, and D are incorrect because Acetylcysteine is not used to suppress cough, cause euphoria, or change urine color. Educating the family on the distinct smell of Acetylcysteine will help them understand its characteristics and alleviate concerns about the odor.

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