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 a new prescription for Filgrastim. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication with food.
• B. Avoid taking this medication with orange juice.
• C. Report bone pain to your healthcare provider.
• D. Expect a persistent cough while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'Report bone pain to your healthcare provider.' Filgrastim is known to cause bone pain as a common side effect. Therefore, it is crucial for clients to report any bone pain to their healthcare provider to monitor for potential complications or the need for further management. Choices A, B, and D are incorrect because taking Filgrastim with food, avoiding it with orange juice, and expecting a persistent cough are not relevant instructions associated with this medication.

3. A healthcare provider is planning to administer Ciprofloxacin IV to a client who has cystitis. Which of the following actions should the healthcare provider take?

• A. Administer a concentrated solution.
• B. Infuse the medication over 60 min.
• C. Infuse the solution through the primary IV fluid tubing.
• D. Choose a small peripheral vein for administration.

Correct answer: B

Rationale: Ciprofloxacin should be infused over 60 minutes to minimize vein irritation and reduce the risk of adverse effects. Administering a concentrated solution can lead to vein irritation and potential complications. Infusing the solution through the primary IV fluid tubing can cause incompatibility issues. Choosing a small peripheral vein may not be suitable for administering Ciprofloxacin, which should be infused through a larger vein to prevent vein irritation and ensure a proper dilution of the medication.

4. During an admission assessment for a client with severe Aspirin toxicity, which finding should the nurse expect?

• A. Body temperature 35°C (95°F)
• B. Lung crackles
• C. Cool, dry skin
• D. Respiratory depression

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression is an anticipated finding due to the development of respiratory acidosis. Aspirin toxicity can lead to metabolic acidosis, causing the individual to hyperventilate initially to compensate. However, as the condition progresses, respiratory depression can occur, resulting in impaired gas exchange and respiratory acidosis.

5. A client has a new prescription for Allopurinol. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication at bedtime.
• B. Increase your fluid intake.
• C. Avoid foods high in calcium.
• D. Take this medication with meals.

Correct answer: B

Rationale: Allopurinol can increase the risk of kidney stones as a side effect. To prevent this adverse effect, it is essential for the client to increase their fluid intake. Adequate hydration can help in preventing the formation of kidney stones by keeping urine dilute and flushing out substances that can lead to stone formation.

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