Nursing Elites

1. A client with breast cancer is receiving cyclophosphamide. Which of the following findings should the nurse monitor?

• A. Hypertension
• B. Hyperglycemia
• C. Ototoxicity
• D. Hemorrhagic cystitis

Correct answer: D

Rationale: The nurse should monitor the client for hemorrhagic cystitis when receiving cyclophosphamide due to its potential to cause bladder irritation and lead to this serious adverse effect. It is essential to assess for symptoms such as hematuria, dysuria, and flank pain. Monitoring for hypertension, hyperglycemia, and ototoxicity is not directly related to the side effects of cyclophosphamide.

2. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include in the discharge teaching?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct instruction for Nitroglycerin sublingual tablets is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. This regimen helps in relieving angina symptoms effectively. Option A of taking one tablet every 15 minutes is too infrequent and may delay symptom relief. Option C of taking one tablet at bedtime is not appropriate as Nitroglycerin is used for immediate relief of angina. Option D of taking one tablet on an empty stomach is irrelevant since Nitroglycerin is not affected by food intake.

3. When providing discharge instructions to a client prescribed Prednisone, which of the following dietary instructions should the nurse include?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Prednisone can lead to potassium depletion, making it essential to consume foods high in potassium, such as bananas, oranges, and spinach, to maintain electrolyte balance and prevent complications. Choice B is incorrect because increasing dairy products is not specifically necessary when taking Prednisone. Choice C is wrong as foods high in vitamin K are not contraindicated with Prednisone. Choice D is incorrect as there is no need to decrease protein intake when prescribed Prednisone.

4. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

• A. Increased renal secretion
• B. Increased medication-metabolizing enzymes
• C. Liver failure
• D. Peripheral vascular disease

Correct answer: C

Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.

5. A client has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?

• A. You should have a high-carbohydrate snack between meals and at bedtime.
• B. You are likely to develop hand tremors if you take this medication for a long period of time.
• C. You may experience temporary numbness of your mouth after each dose.
• D. You should have your white blood cell count monitored every week.

Correct answer: D

Rationale: Clozapine has a risk for fatal agranulocytosis, making weekly monitoring of the client's white blood cell (WBC) count essential to detect any potential issues early. This monitoring helps in managing the risk and ensuring the client's safety while on clozapine.

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