Nursing Elites

1. A client with prostate cancer is receiving leuprolide. Which of the following findings should the nurse monitor?

• A. Increased testosterone levels
• B. Increased libido
• C. Gynecomastia
• D. Hypoglycemia

Correct answer: C

Rationale: The nurse should monitor the client for gynecomastia when receiving leuprolide as it can cause decreased testosterone levels, leading to the development of gynecomastia. Choices A, B, and D are incorrect because leuprolide actually decreases testosterone levels, which would not result in increased testosterone levels or libido. Leuprolide is not associated with hypoglycemia, so monitoring for this is unnecessary in a client receiving this medication.

2. When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?

• A. “Your chest pain should go away with one tablet.”
• B. “If your chest pain doesn’t go away after three tablets, call 911; you might be having a heart attack.”
• C. “If your chest pain doesn’t go away with one tablet, you can repeat the dose as many times as you need to.”
• D. “Be sure to call 911 before you take any tablets.”

Correct answer: B

Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.

3. How can the nurse best explain the difference between angina and a myocardial infarction to a client presenting with severe chest pain?

• A. “Angina usually resolves with rest, and is rarely fatal, while a myocardial infarction necessitates immediate treatment and can be life-threatening.”
• B. “There is a clear distinction between the two. You will receive treatment based on the diagnosis of a myocardial infarction.”
• C. “Both conditions result from a clot obstructing the coronary arteries. Angina occurs with the blockage of a small vessel, whereas a myocardial infarction occurs with a blockage of a large vessel.”
• D. “Angina may not cause as intense chest pain, whereas a myocardial infarction always presents with severe chest pain.”

Correct answer: A

Rationale: When educating a client about the differences between angina and a myocardial infarction, it is crucial to emphasize key distinguishing factors. Angina typically improves with rest and is not usually life-threatening, whereas a myocardial infarction requires urgent intervention as it can be life-threatening. This explanation helps the client understand the urgency and severity associated with a myocardial infarction compared to angina.

4. A client's serum Calcium is 8.8 mg/dL. Which of the following medications should the nurse anticipate administering to this client?

• A. Calcitonin-salmon
• B. Calcium carbonate
• C. Zoledronic acid
• D. Ibandronate

Correct answer: B

Rationale: The client's serum calcium level is below the expected reference range. In this case, the appropriate medication to anticipate administering is Calcium carbonate, an oral form of calcium used to increase serum calcium levels to the expected reference range.

5. A client who is receiving combination chemotherapy is exhibiting a temperature of 38.1°C (100.6°F). 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 undergoing chemotherapy due to the heightened risk of sepsis in immunocompromised individuals. Immediate assessment and intervention are crucial to prevent severe complications. Dry oral mucous membranes, nausea and vomiting, and anorexia are common side effects of chemotherapy but are not specific indicators of an oncologic emergency like a fever in this setting.

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