Nursing Elites

1. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Hyperkalemia
• B. Hypertension
• C. Constipation
• D. Nephrotoxicity

Correct answer: D

Rationale: Correct. Amphotericin B is known for its nephrotoxicity, which can lead to kidney damage. Monitoring kidney function is crucial to detect any signs of nephrotoxicity early. Choices A, B, and C are incorrect because hyperkalemia, hypertension, and constipation are not typically associated with amphotericin B use. Therefore, the nurse should focus on monitoring for nephrotoxicity.

2. A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number).

• A. 21 gtt/min
• B. 20 gtt/min
• C. 25 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To calculate the IV infusion rate in gtt/min: 1000 mL / 480 min × 10 gtt/mL = 20.83 ≈ 21 gtt/min. Therefore, the correct answer is A. Choice B (20 gtt/min) is incorrect because the calculation results in 20.83 gtt/min, rounded to 21. Choices C (25 gtt/min) and D (18 gtt/min) are incorrect as they are not the closest whole number approximation to the calculated value.

3. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?

• A. Increases blood pressure
• B. Prevents esophageal bleeding
• C. Decreases heart rate
• D. Reduces ammonia levels

Correct answer: D

Rationale: The correct answer is D: Reduces ammonia levels. Lactulose is used to reduce blood ammonia levels in clients with hepatic encephalopathy. Options A, B, and C are incorrect because lactulose does not have the therapeutic effect of increasing blood pressure, preventing esophageal bleeding, or decreasing heart rate.

4. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

• A. Antiestrogenic
• B. Antimicrobial
• C. Androgenic
• D. Anti-inflammatory

Correct answer: A

Rationale: Tamoxifen is an antiestrogen medication used primarily in the treatment and prevention of breast cancer. It works by blocking the effects of estrogen in the breast tissue, thereby acting as an antiestrogenic agent. This makes choice A the correct answer. Choice B, antimicrobial, is incorrect as tamoxifen does not possess antimicrobial properties and is not used to treat infections. Choice C, androgenic, is incorrect as tamoxifen has antiestrogenic effects, not androgenic effects. Choice D, anti-inflammatory, is incorrect as tamoxifen's main therapeutic action is antiestrogenic rather than anti-inflammatory.

5. A nurse is preparing a discharge teaching plan for a client who is to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?

• A. Stop taking the medication if a rash occurs.
• B. Take the medication on an empty stomach to enhance absorption.
• C. Schedule the medication on alternate days to decrease adverse effects.
• D. Treat shortness of breath with an extra dose of the medication.

Correct answer: C

Rationale: When initiating long-term oral prednisone therapy for asthma, it is essential to schedule the medication on alternate days. This approach helps reduce the risk of adverse effects commonly associated with corticosteroid use. Choice A is incorrect because abrupt discontinuation of prednisone can lead to adrenal insufficiency. Choice B is incorrect as prednisone should be taken with food to minimize gastrointestinal side effects. Choice D is incorrect because using an extra dose of prednisone to treat shortness of breath is not appropriate and can lead to overdosing.

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