Nursing Elites

1. A healthcare professional is caring for a client who is receiving treatment with carboplatin. Which of the following findings should the healthcare professional monitor?

• A. Hyperglycemia
• B. Ototoxicity
• C. Hypertension
• D. Bradycardia

Correct answer: B

Rationale: The healthcare professional should monitor the client for ototoxicity when receiving carboplatin. Ototoxicity is a known serious adverse effect associated with this medication, characterized by damage to the inner ear structures leading to hearing loss or balance issues. Monitoring for hearing changes and balance problems is crucial to detect ototoxicity early and prevent further complications. Hyperglycemia, hypertension, and bradycardia are not typically associated with carboplatin therapy.

2. When teaching a client with a new prescription for Warfarin, which herbal supplement should the nurse instruct the client to avoid?

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

Correct answer: A

Rationale: The correct answer is St. John's wort. St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism, potentially leading to decreased anticoagulant effects. Therefore, the nurse should instruct the client to avoid using St. John's wort while taking Warfarin to prevent adverse drug interactions. Echinacea, garlic, and ginseng are not the correct answers in this case. While these herbal supplements may also interact with Warfarin and affect its efficacy, St. John's wort has a well-known interaction with Warfarin that can significantly impact its anticoagulant effects. Educating the client about the specific interaction between St. John's wort and Warfarin is crucial to ensure patient safety and the medication's therapeutic benefit.

3. A client has a new prescription for Nevirapine, an NNRTI. Which of the following statements should the nurse include in discharge teaching?

• A. Take this medication with food to increase absorption.
• B. Avoid alcohol while taking this medication.
• C. Take this medication at the same time every day.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: The correct statement to include in discharge teaching about Nevirapine, an NNRTI, is to advise the client to avoid alcohol while taking this medication. Alcohol can interact with Nevirapine and lead to potential adverse effects or decreased effectiveness. Choice A is incorrect because Nevirapine should be taken without food or on an empty stomach for optimal absorption. Choice C is a general recommendation for most medications but not specifically for Nevirapine. Choice D is incorrect as Nevirapine should not be taken on an empty stomach.

4. A healthcare professional in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings is indicative of this condition?

• A. Insidious onset of painless loss of vision
• B. Gradual reduction in peripheral vision
• C. Severe pain around the eyes
• D. Intraocular pressure 12 mm Hg

Correct answer: C

Rationale: Severe pain around the eyes that radiates over the face is a classic symptom of acute angle-closure glaucoma. This intense pain is often associated with other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. Immediate medical attention is required to prevent permanent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more indicative of conditions like macular degeneration. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12 mm Hg is within the normal range and is not typical of angle-closure glaucoma.

5. A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?

• A. Apply the patch to a hairless area of the body.
• B. Remove the patch every 12 hours.
• C. Massage the patch after applying it.
• D. Place the patch over a hairless area of the body.

Correct answer: D

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.

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