Nursing Elites

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

• A. Increased testosterone levels
• B. Increased libido
• C. Gynecomastia
• D. Hypoglycemia

Correct answer: C

Rationale: The nurse should monitor the client for gynecomastia, as it is an adverse effect of leuprolide due to decreased testosterone levels. Leuprolide works by decreasing testosterone production, which can lead to gynecomastia, the development of male breast tissue. Monitoring for this side effect is essential for early detection and intervention.

2. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

3. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: The correct instruction for taking Colesevelam is to take it with food and at least one glass of water. This helps to ensure proper absorption and reduce the risk of gastrointestinal side effects. Option A is incorrect because Digoxin and Colesevelam should not be taken together. Option B is irrelevant to the administration of Colesevelam. Option C is unrelated to the specific instructions for taking Colesevelam.

4. A client has a new prescription for Bisacodyl. Which of the following statements should the nurse include?

• A. Take the medication before bedtime.
• B. Expect a rapid heart rate.
• C. Increase your intake of high-sodium foods.
• D. Expect rectal burning with the suppository form.

Correct answer: D

Rationale: The correct statement to include when educating a client about Bisacodyl is to expect rectal burning with the suppository form. Bisacodyl, a stimulant laxative, is known to cause rectal burning when administered as a suppository. This side effect is common and expected, and it is important for the client to be aware of it to prevent unnecessary alarm or concern. Choices A, B, and C are incorrect. Taking Bisacodyl before bedtime is not a common instruction; expecting a rapid heart rate is not a typical side effect of Bisacodyl; and increasing intake of high-sodium foods is not related to the use of Bisacodyl.

5. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

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