Nursing Elites

1. A healthcare provider is completing a client's medical history. The client takes Simvastatin. The healthcare provider should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in patients with active moderate-to-severe liver disorders, such as active hepatitis C, especially when they are already taking a statin like simvastatin. This combination can increase the risk of liver problems and is not recommended due to the potential for further liver damage. Choices A, B, and D are not directly contraindications for adding Ezetimibe to the client's medications.

2. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

• A. This medication can stain your contacts.
• B. This medication can cause your pupils to constrict.
• C. This medication can absorb into your contacts.
• D. This medication can slow your heart rate.

Correct answer: C

Rationale: The correct instruction the nurse should include is that Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove the contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid any potential absorption of the medication into the lenses. Choices A, B, and D are incorrect because Brimonidine is not known to stain contacts, cause pupil constriction, or slow heart rate.

3. A healthcare professional is educating a client who is beginning therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Prompt reporting of dyspnea allows for timely evaluation and management to prevent potential complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings that the client should report.

4. 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.

5. A client reports taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. When used for more than 5 days, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion, which is an adverse effect to be assessed in the client. Sedation (choice A) is not a common adverse effect of phenylephrine. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with phenylephrine use.

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