Nursing Elites

1. A client has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will need to get my blood drawn periodically while on this medication.
• B. I should stop taking this medication if I develop a rash.
• C. I will need to limit my alcohol intake to no more than one drink per week.
• D. I should self-administer this medication subcutaneously.

Correct answer: A

Rationale: The correct answer is A because Etanercept can cause bone marrow suppression, so it is crucial to monitor blood counts regularly to detect any early signs of adverse effects.

2. When taking Digoxin, low levels of what can cause toxicity?

• A. Potassium
• B. Calcium
• C. Sodium
• D. Magnesium

Correct answer: A

Rationale: Low potassium levels can lead to Digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium pump. When potassium levels are low, there is an increased risk of Digoxin binding and toxicity. Choice B (Calcium) is incorrect because low calcium levels are not directly linked to Digoxin toxicity. Choice C (Sodium) is incorrect as low sodium levels do not cause Digoxin toxicity. Choice D (Magnesium) is incorrect as low magnesium levels do not contribute to Digoxin toxicity.

3. Which of the following is not a side effect of loop diuretics?

• A. Alkalosis
• B. Nausea
• C. Hypotension
• D. Potassium deficits

Correct answer: B

Rationale: Nausea is not commonly associated with loop diuretics. Loop diuretics are known to cause electrolyte imbalances such as potassium deficits, metabolic alkalosis, and hypotension due to excessive fluid loss. Nausea is not a typical side effect of loop diuretics.

4. While caring for a client receiving Heparin therapy, which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. PT
• B. INR
• C. aPTT
• D. Platelet count

Correct answer: C

Rationale: The nurse should monitor the aPTT (activated partial thromboplastin time) when caring for a client receiving Heparin therapy. The aPTT reflects the intrinsic pathway of the clotting cascade and is used to monitor the effectiveness of heparin, which primarily affects this pathway by potentiating antithrombin III. Monitoring the aPTT helps ensure that the client's blood is within the therapeutic range to prevent thrombus formation. Choices A, B, and D are incorrect. PT (Prothrombin Time) and INR (International Normalized Ratio) are used to monitor Warfarin therapy, not Heparin. Platelet count is important in assessing for thrombocytopenia but is not a specific indicator of Heparin therapy effectiveness.

5. A client has a prescription for long-term use of oral prednisone for the treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Oral prednisone can lead to weight gain and fluid retention due to its sodium and water retention effects. Monitoring weight changes is crucial to identify and manage this adverse effect. Choices B, C, and D are incorrect because oral prednisone is not typically associated with nervousness, bradycardia, or constipation as common adverse effects. Therefore, the nurse should primarily focus on monitoring weight gain in clients prescribed long-term oral prednisone therapy.

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