a nurse is teaching a client who is starting therapy with topotecan which of the following findings should the nurse instruct the client to report a nurse is teaching a client who is starting therapy with topotecan which of the following findings should the nurse instruct the client to report
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Nursing Elites

ATI RN

ATI Pharmacology Proctored Exam 2023

1. A client is starting therapy with topotecan. Which of the following findings should the nurse instruct the client to report?

Correct answer: C

Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

2. An infant is diagnosed with a tracheoesophageal fistula. Which assessment finding should the nurse expect?

Correct answer: D

Rationale: Coughing with excessive secretion is a common sign of tracheoesophageal fistula. In this condition, the connection between the trachea and esophagus allows saliva and food to enter the airways, leading to coughing and excessive secretions. Choice A, jaundice, is not typically associated with tracheoesophageal fistula. Hyperactive bowel sounds (Choice B) are more likely seen in conditions like gastroenteritis. Absence of sucking and vomiting (Choice C) is not a typical finding related to tracheoesophageal fistula.

3. Verbal interventions with an agitated patient may be calming. These interventions include:

Correct answer: C

Rationale: The correct answer is C: Remaining calm and keeping an arm's distance. Agitated individuals benefit from minimal verbal and physical stimulation. They respond to their environment based on how nurses interact with them. If an individual feels threatened or cornered, the response will generally be self-protective and reactive. Standing close to the patient (choice D) can be perceived as invasive and may escalate the situation. Holding and reassuring the patient (choice A) may not be effective if the patient perceives it as intrusive. Encouraging other staff to distract the patient (choice B) may introduce unnecessary stimulation. Therefore, the recommended approach is to remain calm and keep a safe distance to provide a non-threatening environment for the agitated patient.

4. The healthcare provider is caring for a client with an altered level of consciousness and needs to assess the withdrawal reflex. Which action should the healthcare provider perform?

Correct answer: A

Rationale: The withdrawal reflex is assessed by applying a painful stimulus and observing if the client pulls away. This response indicates a functioning reflex arc. Choices B, C, and D are incorrect as they do not involve testing the withdrawal reflex specifically. Checking for pupil response to light assesses the pupillary reflex, assessing the client's response to verbal commands evaluates their cognitive function, and observing the client's reaction to a cold stimulus tests for a different type of sensory response.

5. Why does Anita stand in front of the mirror while performing a Breast Self-Examination (BSE)?

Correct answer: C

Rationale: When performing a Breast Self-Examination (BSE), one of the reasons for standing in front of a mirror is to observe the size and contour of the breast (Choice C). This helps in identifying any visible changes or abnormalities such as dimpling, puckering, or changes in the size and shape of the breasts. While unusual discharges (Choice A) and thickness or lumps (Choice D) can be part of the changes a person might notice during a BSE, these are typically identified by palpation or by squeezing the nipple for discharge, not by just looking in the mirror. Choice B, checking for obvious malignancy, is too vague and not specific enough as malignancy is often not visible to the naked eye.

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