Nursing Elites

1. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously for Rheumatoid Arthritis. Injection-site reactions such as redness and swelling are common. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for potential adverse effects.

2. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?

• A. Vitamin K1
• B. Protamine
• C. Omeprazole
• D. Probenecid

Correct answer: C

Rationale: Omeprazole, a proton pump inhibitor, is prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help manage these symptoms effectively. Choice A, Vitamin K1, is incorrect as it antagonizes the activity of Dabigatran, counteracting its anticoagulant effect. Choice B, Protamine, is used to reverse the anticoagulant effects of heparin, not dabigatran. Choice D, Probenecid, is not typically used to treat adverse effects of dabigatran.

3. A client with chronic myeloid leukemia is receiving hydroxyurea. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Hypertension
• C. Neutropenia
• D. Tinnitus

Correct answer: C

Rationale: The nurse should monitor the client for neutropenia when receiving hydroxyurea, as it is a common adverse effect caused by bone marrow suppression. Neutropenia increases the risk of infections, making it crucial for the nurse to closely monitor the client's white blood cell count.

4. When teaching a patient to take their own pulse, which medication should the nurse instruct them to monitor? (Hint: if pulse is <60 or >100, the patient should contact their healthcare provider before taking the medication)

• A. Digoxin
• B. Lithium
• C. Montelukast
• D. Phenytoin

Correct answer: A

Rationale: It is essential for patients taking Digoxin to monitor their pulse regularly. If their pulse falls below 60 or exceeds 100 beats per minute, they should contact their healthcare provider immediately. This is crucial due to Digoxin's potential to affect heart rate, making pulse monitoring a vital aspect of patient care while on this medication.

5. Which medication is contraindicated with Nitroglycerin?

• A. Hydrochloroquine
• B. Methylprednisolone
• C. Phenazopyridine
• D. Erectile dysfunction drugs

Correct answer: D

Rationale: The correct answer is D: Erectile dysfunction drugs. Erectile dysfunction drugs are contraindicated with Nitroglycerin because they can potentiate the hypotensive effects of Nitroglycerin, leading to severe hypotension. Choices A, B, and C are incorrect because they are not known to have significant interactions with Nitroglycerin.

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