Nursing Elites

1. A client with chronic myeloid leukemia is receiving hydroxyurea. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Hypertension
• C. Neutropenia
• D. Tinnitus

Correct answer: C

Rationale: The nurse should monitor the client for neutropenia when receiving hydroxyurea. Neutropenia is a common adverse effect caused by bone marrow suppression. It is essential to assess the client's white blood cell count regularly to detect neutropenia early and prevent complications such as infections.

2. What instruction should the healthcare provider include to minimize an adverse effect of Clomipramine for OCD in an adolescent client?

• A. Wear sunglasses when outdoors.
• B. Check your temperature daily.
• C. Take this medication in the morning.
• D. Add extra calories to your diet.

Correct answer: A

Rationale: The correct answer is A: 'Wear sunglasses when outdoors.' To minimize the anticholinergic effect of Clomipramine, the client should wear sunglasses when outdoors to reduce photophobia. This adverse effect is common with tricyclic antidepressant (TCA) use. Choices B, C, and D are incorrect. Checking temperature daily, timing of medication intake, or adding extra calories to the diet are not directly related to minimizing adverse effects of Clomipramine.

3. A client has a new prescription for Nitroglycerin to treat angina. Which of the following instructions should the nurse include?

• A. Take this medication only when chest pain occurs.
• B. Store the medication in a cool, dry place.
• C. Apply the patch to a different site each time.
• D. Avoid consuming alcohol while taking this medication.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to apply the Nitroglycerin patch to a different site each time. This is crucial to prevent skin irritation and ensure consistent absorption of the medication. Rotating application sites is important as it helps maintain the effectiveness of the treatment and reduces the risk of skin reactions. Choice A is incorrect because Nitroglycerin is often used prophylactically to prevent angina episodes rather than just for acute chest pain. Choice B is not relevant to the administration or effectiveness of the medication. Choice D, while generally a good recommendation, is not directly related to the administration of Nitroglycerin.

4. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify the trough levels of a medication accurately, the nurse should obtain a blood specimen immediately before administering the next dose of the medication. The trough level represents the lowest concentration of the medication in the bloodstream, typically right before the next dose is due. This timing ensures an accurate assessment of the drug's concentration in the body at its lowest point, aiding in determining the drug's effectiveness and potential toxicity levels. Choice B is incorrect because waiting for 24 hours would not provide the trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect as obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level.

5. A client in the operating room received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and their body temperature begins to rise. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Neostigmine
• B. Naloxone
• C. Dantrolene
• D. Vecuronium

Correct answer: C

Rationale: Muscle rigidity and a sudden rise in temperature are manifestations of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic activity and treat malignant hyperthermia effectively. Neostigmine (choice A) is used to reverse the effects of non-depolarizing neuromuscular blockers, not to treat malignant hyperthermia. Naloxone (choice B) is an opioid antagonist used for opioid overdose. Vecuronium (choice D) is a non-depolarizing neuromuscular blocker and is not used to treat malignant hyperthermia.

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