Nursing Elites

1. A client has a new prescription for Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the following adverse reactions?

• A. Bone marrow suppression
• B. Pancreatitis
• C. Pancreatitis
• D. Bone marrow suppression

Correct answer: D

Rationale: While bone marrow suppression is not typically associated with Enfuvirtide, a more relevant concern is the risk of severe allergic reactions such as anaphylaxis. Enfuvirtide, an HIV fusion inhibitor, can cause local injection site reactions and systemic allergic responses. Monitoring for signs of allergic reactions, such as rash, fever, and difficulty breathing, is crucial to ensure the client's safety.

2. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

• A. The client will start at a high dose, and the dose will be tapered as needed.
• B. The client will remain on the initial dosage during the course of treatment.
• C. The client's dosage will be adjusted daily based on blood levels.
• D. The client will start on a low dose, which will be gradually increased.

Correct answer: D

Rationale: The nurse should expect that levothyroxine will be started at a low dose and gradually increased over several weeks. This cautious approach is crucial, especially in older adult clients, to prevent toxicity and ensure optimal therapeutic outcomes for managing hypothyroidism. Choice A is incorrect because starting at a high dose and tapering as needed is not the standard approach for levothyroxine. Choice B is incorrect because the initial dosage is typically adjusted to reach the optimal therapeutic dose. Choice C is incorrect as adjusting the dosage daily based on blood levels is not necessary for levothyroxine, as it has a long half-life and requires time to reach a steady state.

3. A client has a prescription for Amphotericin B. Which of the following laboratory values should be monitored by the nurse to assess for an adverse effect of this medication?

• A. Serum creatinine.
• B. Serum potassium.
• C. Serum sodium.
• D. Serum calcium.

Correct answer: A

Rationale: Corrected Rationale: Amphotericin B is known to cause nephrotoxicity, a potential adverse effect that can be monitored by checking the client's serum creatinine levels. Regular monitoring of serum creatinine helps in early identification of kidney damage and allows for timely intervention to prevent further complications. Choice B, serum potassium, is not typically associated with adverse effects of Amphotericin B. Choice C, serum sodium, and choice D, serum calcium, are not directly affected by Amphotericin B and are not primary indicators of its adverse effects.

4. A healthcare professional is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the healthcare professional prepare to transfuse?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the correct choice for a client with an elevated aPTT because it contains essential coagulation factors that can help correct coagulopathy and prevent bleeding. It is rich in clotting factors like fibrinogen, factors V and VIII, which are crucial in maintaining proper blood clotting function. Whole blood (Choice A) is not typically used to correct coagulopathy and is more suitable for situations requiring both volume and oxygen-carrying capacity. Platelets (Choice B) are indicated for thrombocytopenia, not for correcting coagulation factors. Packed red blood cells (Choice D) are used to increase oxygen-carrying capacity in cases of anemia, not for correcting coagulopathy.

5. What is pharmacodynamics?

• A. The medical reference summarizing standards of drug purity, strength, and directions for synthesis
• B. The drug's actions at receptor sites and the physiological, chemical, and behavioral effects produced by these actions
• C. The maximum response that a drug can produce
• D. Movements of the drugs throughout the body

Correct answer: B

Rationale: Pharmacodynamics refers to the drug's actions at receptor sites and the physiological, chemical, and behavioral effects produced by these actions. It involves understanding how drugs interact with the body at the molecular level to produce their effects, including mechanisms of action, receptor binding, and downstream physiological responses. Choice A is incorrect because it describes pharmacopeia, which is a reference book containing standards for drugs. Choice C refers to efficacy, which is the maximum effect a drug can produce. Choice D describes pharmacokinetics, which focuses on the movement of drugs within the body.

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