Nursing Elites

1. A client with cancer and a prescription for methotrexate PO reports bleeding gums while being assessed by a nurse in a provider's clinic. Which of the following actions should the nurse take?

• A. Explain to the client that this is an expected adverse effect.
• B. Check the value of the client's current platelet count.
• C. Instruct the client to use an electric toothbrush.
• D. Have the client make an appointment to see the dentist.

Correct answer: B

Rationale: The correct action for the nurse to take when a client on methotrexate reports bleeding gums is to check the client's current platelet count. Bleeding gums may indicate thrombocytopenia, a decreased platelet count which can be a severe side effect of methotrexate therapy. Monitoring the platelet count is crucial for early detection and management of this potentially life-threatening complication. Choice A is incorrect as bleeding gums in this context may not be an expected adverse effect of methotrexate. Choice C is irrelevant and does not address the potential underlying issue of thrombocytopenia. Choice D is not the primary action needed at this point; checking the platelet count is more urgent to assess the severity of the situation.

2. A client has a new prescription for Nitrofurantoin. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid dairy products while taking this medication.
• C. Take this medication at bedtime.
• D. Increase your intake of vitamins.

Correct answer: A

Rationale: The correct instruction for a client prescribed Nitrofurantoin is to take the medication with food. Taking Nitrofurantoin with food helps enhance absorption and reduces the risk of gastrointestinal side effects. It is important for the nurse to emphasize this instruction to ensure the client benefits optimally from the medication. Choices B, C, and D are incorrect. Avoiding dairy products is not specifically required with Nitrofurantoin. Taking the medication at bedtime is not a standard instruction. Increasing vitamin intake is not necessary in relation to Nitrofurantoin therapy.

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

• A. Take this medication with food.
• B. Avoid taking aspirin while on this medication.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: When a client is prescribed Clopidogrel, an antiplatelet medication, the nurse should instruct them to avoid taking aspirin or other NSAIDs. This is because both medications can increase the risk of bleeding when taken together, potentially leading to serious health complications. Therefore, it is crucial for the client to follow this instruction to ensure their safety and well-being while on Clopidogrel. Choices A, C, and D are incorrect because taking Clopidogrel with food, avoiding foods high in potassium, or taking the medication at bedtime are not specific instructions related to the safe use of Clopidogrel and do not address the potential interaction with aspirin, which is essential for the client's well-being.

4. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.

5. Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?

• A. Antiplatelets
• B. Beta-adrenergic blockers
• C. ACE inhibitors
• D. Calcium channel blockers

Correct answer: B

Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.

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