Nursing Elites

1. When is the best time for a client to take a daily dose of prednisone?

• A. At noon
• B. At bedtime
• C. Early morning
• D. Anytime, at the same time each day

Correct answer: C

Rationale: The correct time for a client to take a daily dose of prednisone is early morning. Corticosteroids like prednisone should be taken in the morning to mimic the body's natural hormone release pattern. This timing helps reduce the risk of disrupting the body's internal clock and minimizes the potential for insomnia or other sleep disturbances.

2. The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value should the nurse specifically monitor during treatment with this medication?

• A. Clotting time
• B. Uric acid level
• C. Potassium level
• D. Blood glucose level

Correct answer: B

Rationale: The correct answer is B, Uric acid level. Busulfan can cause an increase in uric acid levels, leading to hyperuricemia, renal stones, and acute renal failure. Monitoring uric acid levels is crucial to detect and manage potential complications associated with busulfan therapy.

3. The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:

• A. Take the medication with food.
• B. Increase fluid intake to 2000 to 3000 mL daily.
• C. Decrease sodium intake while taking the medication.
• D. Increase potassium intake while taking the medication.

Correct answer: B

Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.

4. A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:

• A. Should always be taken with food or antacids
• B. Should be double-dosed if one dose is forgotten
• C. Causes orange discoloration of sweat, tears, urine, and feces
• D. May not be discontinued independently if symptoms are gone in 3 months

Correct answer: C

Rationale: Rifampin causes orange-red discoloration of body secretions, including sweat, tears, urine, and feces. It can also permanently stain soft contact lenses. It is essential to take rifampin exactly as directed and not discontinue it without consulting the healthcare provider.

5. A client with hypertension is prescribed clonidine (Catapres) transdermal patch. Which statement by the client indicates an understanding of the medication?

• A. I should change the patch daily.
• B. I should remove the old patch before applying a new one.
• C. I should avoid alcohol consumption while using this patch.
• D. I should apply the patch to different sites each time.

Correct answer: B

Rationale: The correct answer is B. The client should remove the old clonidine (Catapres) patch before applying a new one to prevent overdose. The patch is typically changed every 7 days. Avoiding alcohol consumption is important as it can potentiate the sedative effects of clonidine. It is recommended to rotate application sites to prevent skin irritation and ensure optimal drug absorption.

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