Nursing Elites

1. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of a transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously. Injection-site redness and swelling are common adverse effects. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for any potential issues or reactions.

2. A client is starting therapy with filgrastim, and a nurse is providing teaching on monitoring adverse effects. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bone pain
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Bone pain. The nurse should instruct the client to monitor for bone pain since it is a common adverse effect of filgrastim. This occurs due to increased bone marrow activity stimulated by the medication.

3. A male client recently started taking Haloperidol. Which of the following findings is the highest priority to report to the provider?

• A. Shuffling gait
• B. Neck spasms
• C. Drowsiness
• D. Impotence

Correct answer: B

Rationale: Neck spasms are an indication of acute dystonia, a serious side effect of Haloperidol that can quickly progress to a crisis situation. Immediate medical attention is necessary to prevent complications. Shuffling gait and drowsiness are common side effects of Haloperidol but are not as urgent as neck spasms. Impotence is not typically associated with Haloperidol use. Therefore, identifying neck spasms as the priority finding is crucial for the client's safety.

4. A client is receiving Morphine IV for pain management. Which of the following actions should the nurse take?

• A. Monitor the client's respiratory rate every 15 minutes.
• B. Monitor the client's blood pressure every 30 minutes.
• C. Monitor the client's oxygen saturation every hour.
• D. Monitor the client's heart rate every 5 minutes.

Correct answer: A

Rationale: The correct action for the nurse is to monitor the client's respiratory rate every 15 minutes while on Morphine IV to promptly detect respiratory depression, a critical adverse effect associated with this medication. Respiratory depression is a common side effect of opioid medications like Morphine and can be life-threatening. Monitoring the respiratory rate frequently enables the nurse to identify early signs of respiratory compromise and intervene promptly. Monitoring other vital signs like blood pressure, oxygen saturation, or heart rate is important but not as crucial as monitoring respiratory rate when a client is on Morphine IV.

5. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.

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