Nursing Elites

1. A healthcare professional is educating a client who is starting 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 healthcare professional should instruct the client to report dyspnea since it can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Monitoring and reporting dyspnea promptly can help in early detection and management of potential serious complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are not urgent findings requiring immediate reporting.

2. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is 'A: Somnolence.' Somnolence can indicate lactic acidosis, which is manifested by extreme drowsiness, hyperventilation, and muscle pain. It is a rare but very serious adverse effect caused by metformin and should be reported to the provider promptly to prevent further complications.

3. A client has a new prescription for a Fentanyl transdermal patch. Which of the following instructions should the nurse include?

• A. Apply the patch to a non-hairy area.
• B. Change the patch every 72 hours.
• C. Avoid exposure to heat sources.
• D. Do not cut the patch to adjust the dosage.

Correct answer: C

Rationale: The correct instruction the nurse should include for a client using a Fentanyl transdermal patch is to avoid exposure to heat sources. Heat can increase the absorption of the medication, potentially causing an overdose. Instructing the client to avoid heat sources is crucial to ensure their safety and the effectiveness of the medication. Choices A, B, and D are incorrect because applying the patch to a non-hairy area, changing it every 72 hours, and not cutting the patch are general guidelines for using transdermal patches but do not specifically address the unique risks associated with Fentanyl patches.

4. A healthcare provider is caring for a client who has a new prescription for Epoetin Alfa. Which of the following laboratory values should the healthcare provider monitor?

• A. WBC count.
• B. Platelet count.
• C. Hemoglobin.
• D. Serum potassium.

Correct answer: C

Rationale: Epoetin alfa is a medication that stimulates red blood cell production, so hemoglobin levels should be monitored to assess the effectiveness of the drug. Monitoring hemoglobin levels helps evaluate the response to Epoetin Alfa treatment and ensures that the client's anemia is being appropriately managed.

5. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

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