Nursing Elites

1. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

2. A client with breast cancer is being taught by a nurse about the adverse effects of chemotherapy. Which of the following statements should the nurse include?

• A. You should use a soft-bristled toothbrush to prevent bleeding.
• B. You should avoid contact with individuals who recently received live virus vaccines.
• C. You should take aspirin for minor aches and pains.
• D. You should consume a diet low in protein to reduce the risk of renal damage.

Correct answer: A

Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia. Chemotherapy can decrease platelet counts, leading to an increased risk of bleeding. Using a soft-bristled toothbrush can help prevent gum bleeding and oral trauma. Choices B, C, and D are incorrect. Avoiding contact with individuals who recently received live virus vaccines is crucial to prevent infections in immunocompromised clients. Aspirin should be avoided due to its blood-thinning effects that can increase the risk of bleeding. A diet low in protein is not recommended as cancer clients often require adequate protein intake for healing and recovery.

3. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?

• A. Decreased appetite
• B. Explosive diarrhea
• C. Decreased pulse rate
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is 'Orthostatic hypotension.' When administering Amitriptyline, the nurse should monitor for orthostatic hypotension. This condition can occur due to the drug's anticholinergic effects, leading to a sudden drop in blood pressure when standing up. Symptoms may include dizziness, lightheadedness, and an increased risk of falls. Monitoring for signs of orthostatic hypotension is crucial to prevent complications. Choices A, B, and C are incorrect as decreased appetite, explosive diarrhea, and decreased pulse rate are not typically associated with the administration of Amitriptyline.

4. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?

• A. Excessive doxorubicin can result in myelosuppression.
• B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
• C. An excess amount of doxorubicin can lead to cardiomyopathy.
• D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.

Correct answer: C

Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.

5. Which of the following conditions is not treated with Dexamethasone?

• A. Inflammation
• B. Asthma
• C. Addison’s disease
• D. Wilson’s disease

Correct answer: D

Rationale: Dexamethasone is not used to treat Wilson’s disease. It is a corticosteroid primarily used for conditions like inflammation, asthma, and Addison’s disease. Wilson’s disease is a genetic disorder involving copper accumulation and is treated with medications like chelating agents or zinc salts, not Dexamethasone.

Similar Questions