Nursing Elites

1. While caring for a client receiving epoetin alfa to treat anemia, which finding should the nurse monitor for?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Leukocytosis (increased white blood cells) and hyperkalemia (high potassium levels) are not typically associated with epoetin alfa therapy. Fever is also not a common adverse effect of this medication.

2. A client has been prescribed Prednisone for asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take this medication with food to prevent nausea.
• B. Take this medication at bedtime to reduce drowsiness.
• C. Take this medication in the morning to reduce insomnia.
• D. Avoid sudden changes in position.

Correct answer: C

Rationale: Prednisone is best taken in the morning to reduce the risk of insomnia, a common side effect of corticosteroids. Instructing the client to take the medication in the morning aligns with the goal of minimizing the impact of insomnia, which can disrupt sleep patterns and affect overall well-being. Choices A, B, and D are incorrect. Taking Prednisone with food does not primarily focus on preventing nausea; taking it at bedtime does not primarily reduce drowsiness, and avoiding sudden changes in position is not a specific instruction related to Prednisone use for asthma.

3. A patient is receiving IV heparin for a deep-vein thrombosis and begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: Protamine is the antidote for heparin, as it reverses its anticoagulant effects. In cases of heparin overdose or if there is excessive bleeding, administering protamine can quickly neutralize the effects of heparin, helping to prevent further bleeding complications.

4. When providing discharge instructions to a client prescribed Prednisone, which of the following dietary instructions should the nurse include?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Prednisone can lead to potassium depletion, making it essential to consume foods high in potassium, such as bananas, oranges, and spinach, to maintain electrolyte balance and prevent complications. Choice B is incorrect because increasing dairy products is not specifically necessary when taking Prednisone. Choice C is wrong as foods high in vitamin K are not contraindicated with Prednisone. Choice D is incorrect as there is no need to decrease protein intake when prescribed Prednisone.

5. A client with breast cancer is being taught about Tamoxifen. Which of the following adverse effects of tamoxifen should the client be informed about?

• A. Irregular heart rhythm
• B. Abnormal uterine bleeding
• C. Yellowing of the sclera or dark-colored urine
• D. Difficulty swallowing

Correct answer: B

Rationale: Abnormal uterine bleeding is a known adverse effect of tamoxifen. It is important to educate the client about this side effect as those taking tamoxifen are at an increased risk for endometrial cancer. Any abnormal uterine bleeding should be promptly reported and evaluated by healthcare providers to ensure timely management and monitoring. The other options, such as irregular heart rhythm, yellowing of the sclera or dark-colored urine, and difficulty swallowing, are not typically associated with tamoxifen use and are not commonly reported adverse effects. Therefore, they are not the priority adverse effects to inform the client about.

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