Nursing Elites

1. A nurse is caring for a client receiving theophylline for chronic obstructive pulmonary disease (COPD). Which of the following client findings indicates the need for immediate intervention?

• A. Productive cough
• B. Drowsiness
• C. Vomiting
• D. Polyuria

Correct answer: D

Rationale: Polyuria is a sign of theophylline toxicity and requires immediate intervention. Theophylline toxicity can lead to serious complications, and polyuria is a concerning symptom that indicates the need for urgent medical attention. Productive cough, drowsiness, and vomiting are common side effects of theophylline but are not typically indicative of immediate life-threatening issues like polyuria in the context of theophylline toxicity.

2. A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: A

Rationale: Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.

3. A 45-year-old client is taking methylprednisolone. What pharmacologic action should the nurse expect with this therapy?

• A. Suppression of beta2 receptors
• B. Suppression of airway mucus production
• C. Fortification of bones
• D. Suppression of candidiasis

Correct answer: B

Rationale: The correct answer is B: Suppression of airway mucus production. Corticosteroids like methylprednisolone are known to suppress airway mucus production. This action helps in reducing inflammation and swelling in the airways, making breathing easier for individuals with conditions like asthma or COPD. Choices A, C, and D are incorrect. Suppression of beta2 receptors is more related to beta-blockers, fortification of bones is associated with medications like bisphosphonates, and suppression of candidiasis is not a typical pharmacologic action of methylprednisolone.

4. A client receiving epoetin alfa therapy for anemia is being monitored for therapeutic effects. Which of the following laboratory values indicates the medication is effective?

• A. White blood cell count
• B. Hematocrit
• C. Platelet count
• D. Red blood cell count

Correct answer: B

Rationale: The correct answer is B: Hematocrit. An increase in hematocrit levels indicates the effectiveness of epoetin alfa in treating anemia. Hematocrit reflects the percentage of red blood cells in the blood, so an increase in hematocrit signifies an improvement in the patient's red blood cell count and oxygen-carrying capacity. Choices A, C, and D are incorrect because white blood cell count, platelet count, and red blood cell count do not directly reflect the therapeutic effects of epoetin alfa in treating anemia.

5. A nurse is preparing to administer nitroglycerin ointment to a client. Which of the following actions should the nurse take?

• A. Apply the ointment to the client's hairless chest
• B. Rub the ointment gently into the skin
• C. Cover the applied ointment with a transparent dressing
• D. Massage the ointment into the skin

Correct answer: A

Rationale: The correct action is to apply the nitroglycerin ointment to a hairless area of the client's chest, back, or upper arms. This allows for better absorption of the medication. Choice B is incorrect because rubbing the ointment gently into the skin may be appropriate, but the primary action is to ensure application on a hairless area. Choice C is incorrect as covering the ointment with a transparent dressing is not a standard practice for nitroglycerin ointment administration. Choice D is incorrect because massaging the ointment into the skin is not recommended, as it can alter absorption rates.

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