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. A client has a new prescription for Metoclopramide to treat nausea. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication before bedtime.
• B. I will discontinue this medication if I experience drowsiness.
• C. I should report restlessness or involuntary movements.
• D. This medication can change the color of my urine to orange.

Correct answer: C

Rationale: The correct answer is C. Reporting restlessness or involuntary movements is crucial as they can be signs of extrapyramidal symptoms, a potential side effect of Metoclopramide. These symptoms should be reported promptly to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because taking the medication before bedtime, discontinuing it due to drowsiness, or expecting urine color changes are not relevant teaching points for Metoclopramide use.

3. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

4. A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by affecting its metabolism. Echinacea, garlic, and ginseng are also known to interact with Warfarin, either by increasing the risk of bleeding or altering its anticoagulant effects. However, St. John's wort is particularly significant due to its potent enzyme-inducing properties that can lead to subtherapeutic levels of Warfarin, potentially increasing the risk of blood clots.

5. When should a blood sample be obtained for a peak serum level of gentamicin when administered by IV infusion for 1 hour at 0900?

• A. 1000
• B. 1030
• C. 1100
• D. 1130

Correct answer: B

Rationale: The nurse should obtain the blood sample for the peak serum level at 1030. This timing allows for 30 minutes to elapse after the completion of the 1-hour IV infusion, which is the recommended window for obtaining the peak serum level of gentamicin.

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