Nursing Elites

1. A client has a new prescription for Spironolactone. Which of the following instructions should be provided?

• A. Take the medication with food.
• B. Avoid potassium-rich foods.
• C. Increase your intake of sodium.
• D. Monitor your blood pressure daily.

Correct answer: B

Rationale: The correct answer is to 'Avoid potassium-rich foods.' Spironolactone is a potassium-sparing diuretic, and consuming foods high in potassium can lead to hyperkalemia, a potential side effect of the medication. Therefore, the client should be advised to avoid potassium-rich foods to prevent complications. Choices A, C, and D are incorrect. Taking Spironolactone with food is not necessary for its effectiveness. Increasing sodium intake is not typically recommended with Spironolactone therapy. While monitoring blood pressure is important, it is not specifically related to the use of Spironolactone.

2. A client is starting therapy with rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The nurse should instruct the client to report fever when starting rituximab therapy. Fever can be a sign of infection, which is a potential complication associated with rituximab. Early detection and treatment of infections are important to ensure the client's safety and well-being. Dizziness, urinary frequency, and dry mouth are not commonly associated with rituximab therapy and are less likely to be directly related to the medication's side effects. Therefore, fever is the most crucial symptom to report to healthcare providers.

3. A client has a new prescription for Filgrastim. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication with food.
• B. Avoid taking this medication with orange juice.
• C. Report bone pain to your healthcare provider.
• D. Expect a persistent cough while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'Report bone pain to your healthcare provider.' Filgrastim is known to cause bone pain as a common side effect. Therefore, it is crucial for clients to report any bone pain to their healthcare provider to monitor for potential complications or the need for further management. Choices A, B, and D are incorrect because taking Filgrastim with food, avoiding it with orange juice, and expecting a persistent cough are not relevant instructions associated with this medication.

4. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.

5. A client reports taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

• A. Sedation
• B. Nasal congestion
• C. Productive cough
• D. Constipation

Correct answer: B

Rationale: The correct answer is B: Nasal congestion. When used for more than 5 days, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion, which is an adverse effect to be assessed in the client. Sedation (choice A) is not a common adverse effect of phenylephrine. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with phenylephrine use.

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