Nursing Elites

1. 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.

2. A client is starting therapy with docetaxel. Which of the following findings should the nurse instruct the client to report?

• A. Flushing
• B. Dyspnea
• C. Hyperglycemia
• D. Tinnitus

Correct answer: B

Rationale: The correct answer is B: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a serious adverse effect of docetaxel. Dyspnea may be a sign of a potentially life-threatening condition that the healthcare provider needs to address promptly. Flushing (Choice A) is not typically associated with docetaxel therapy. Hyperglycemia (Choice C) is also not a common side effect of docetaxel. Tinnitus (Choice D) is not a usual finding with docetaxel and is not a priority over potential pulmonary toxicity indicated by dyspnea.

3. A client has a new prescription for Iron supplements. Which of the following instructions should be included?

• A. Take the medication with a glass of milk.
• B. Avoid taking the medication with orange juice.
• C. Increase fiber intake to prevent constipation.
• D. Expect stools to be bright red.

Correct answer: C

Rationale: The correct answer is C: 'Increase fiber intake to prevent constipation.' Iron supplements commonly cause constipation as a side effect. Increasing fiber intake can help alleviate this issue by promoting regular bowel movements and preventing constipation. Choice A is incorrect as iron absorption is hindered when taken with milk. Choice B is not directly related to iron supplements. Choice D is incorrect as iron supplements do not typically cause bright red stools.

4. A client with cirrhosis is about to receive a dose of lactulose. The client questions the need for the medication, stating they are not constipated. The nurse should explain that lactulose is used in cirrhosis to reduce levels of which component in the bloodstream?

• A. Glucose
• B. Ammonia
• C. Potassium
• D. Bicarbonate

Correct answer: B

Rationale: Lactulose is administered to clients with cirrhosis to lower blood ammonia levels, thus aiding in the prevention of hepatic encephalopathy. Elevated ammonia levels in cirrhosis can lead to cognitive impairment and hepatic encephalopathy. Therefore, the correct answer is B (Ammonia). Glucose (Choice A) is not the component targeted by lactulose in cirrhosis. Potassium (Choice C) and Bicarbonate (Choice D) are not directly affected by lactulose administration in cirrhosis.

5. When educating a client who has a prescription for Propranolol, what instruction should the healthcare provider include?

• A. Take this medication with food.
• B. Discontinue the medication if you feel fatigued.
• C. Expect to have decreased heart rate with this medication.
• D. Do not stop taking this medication abruptly.

Correct answer: D

Rationale: The correct instruction for a client with a prescription for Propranolol is not to stop taking the medication abruptly. Abrupt cessation can result in rebound hypertension or other cardiac complications. It is crucial for the client to taper off the medication gradually under healthcare provider supervision to prevent adverse effects. Choice A is incorrect because Propranolol can be taken with or without food. Choice B is incorrect as discontinuing the medication based on fatigue alone is not advisable without consulting a healthcare provider. Choice C is incorrect because while Propranolol can decrease heart rate, it is not the primary instruction to provide in this scenario.

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