Nursing Elites

1. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Monitor for signs of hyperglycemia.
• C. Avoid drinking grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication, which can potentiate its effects, potentially causing adverse reactions like hypotension and bradycardia. Choices A, B, and D are incorrect. Taking Verapamil at bedtime is not a specific instruction related to its metabolism or side effects. Monitoring for signs of hyperglycemia is not directly related to Verapamil use. Increasing potassium-rich foods intake is not necessary with Verapamil and could potentially lead to hyperkalemia in some cases.

2. A client has a new prescription for Filgrastim to treat neutropenia. Which of the following statements should the nurse include?

• A. This medication will help increase your white blood cell count.
• B. This medication will help reduce your risk of infection.
• C. This medication will help improve your red blood cell count.
• D. This medication will help increase your platelet count.

Correct answer: A

Rationale: The correct statement the nurse should include is that 'This medication will help increase your white blood cell count.' Filgrastim is a medication used to stimulate the production of white blood cells, specifically neutrophils, to increase the white blood cell count. This increase in white blood cells helps reduce the risk of infections in clients with neutropenia. Choices B, C, and D are incorrect because Filgrastim specifically targets white blood cells, not red blood cells or platelets.

3. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.

4. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

5. A client is prescribed levothyroxine for hypothyroidism. Which of the following findings should indicate to the nurse that the medication is effective?

• A. Decreased heart rate
• B. Increased energy levels
• C. Weight loss
• D. Improved mental clarity

Correct answer: B

Rationale: Increased energy levels are a key indicator of the effectiveness of levothyroxine in treating hypothyroidism. Levothyroxine works to regulate thyroid hormone levels, which can lead to improved energy levels as the body's metabolism is restored. While the other options may also improve with treatment, increased energy levels directly reflect the correction of the thyroid hormone imbalance. Decreased heart rate can be an indicator of overmedication, weight loss can be attributed to increased metabolism but may not directly reflect the effectiveness of levothyroxine, and improved mental clarity is a more general cognitive improvement that may not directly relate to thyroid function.

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