Nursing Elites

1. A client is receiving treatment with capecitabine. Which of the following findings should the nurse monitor?

• A. Hyperglycemia
• B. Hypocalcemia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: Capecitabine is known to cause neutropenia as a common adverse effect due to bone marrow suppression. Neutropenia increases the risk of infections and requires close monitoring to prevent complications. Hyperglycemia (Choice A) is not typically associated with capecitabine. Hypocalcemia (Choice B) and Bradycardia (Choice D) are not commonly linked to capecitabine use, making them incorrect choices.

2. A client is taking Warfarin for atrial fibrillation. Which of the following client statements indicates a need for further teaching?

• A. I will avoid eating broccoli.
• B. I will use an electric razor to shave.
• C. I will take aspirin for headaches.
• D. I will have my blood tested regularly.

Correct answer: C

Rationale: The correct answer is C. Taking aspirin along with Warfarin can increase the risk of bleeding. Clients should be advised to avoid medications that increase the risk of bleeding when taking Warfarin to prevent complications. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding foods high in Vitamin K, using an electric razor to prevent cuts that can lead to bleeding, and regular blood testing to monitor Warfarin levels are all important aspects of managing Warfarin therapy.

3. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

4. A client with a new prescription for Escitalopram for the treatment of generalized anxiety disorder is being taught by a healthcare provider. Which statement by the client indicates understanding of the teaching?

• A. I should take the medication on an empty stomach.
• B. I will follow a low-sodium diet while taking this medication.
• C. I need to discontinue this medication slowly.
• D. I should not crush this medication before swallowing.

Correct answer: C

Rationale: The correct answer is C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. This gradual reduction helps minimize potential withdrawal symptoms and ensures a safer discontinuation process. Choices A, B, and D are incorrect because taking escitalopram on an empty stomach, following a low-sodium diet, and not crushing the medication are not directly related to the safe and effective use of the medication or its discontinuation process.

5. A client has a new prescription for Prednisone. Which of the following instructions should be included in the discharge teaching?

• A. Increase your intake of potassium-rich foods.
• B. Avoid consuming grapefruit juice.
• C. Take this medication with food.
• D. Decrease your intake of sodium-rich foods.

Correct answer: A

Rationale: The correct answer is A: "Increase your intake of potassium-rich foods." Prednisone is associated with potassium depletion, making it important for clients to increase their intake of potassium-rich foods to prevent potential imbalances. Foods such as bananas, oranges, and spinach are good sources of potassium. Choice B, "Avoid consuming grapefruit juice," is not directly related to Prednisone use. Choice C, "Take this medication with food," is a general instruction for many medications but not specific to Prednisone. Choice D, "Decrease your intake of sodium-rich foods," is not directly related to Prednisone's side effects.

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