Nursing Elites

1. A client receiving chemotherapy reports nausea and vomiting. Which of the following medications should the nurse anticipate administering?

• A. Ondansetron
• B. Metoclopramide
• C. Promethazine
• D. Lorazepam

Correct answer: A

Rationale: The correct answer is A: Ondansetron. Ondansetron is a commonly used antiemetic for managing nausea and vomiting in clients undergoing chemotherapy. It works by blocking serotonin to reduce these symptoms effectively. Metoclopramide (choice B) is another antiemetic but is more commonly used for gastric motility disorders. Promethazine (choice C) is an antihistamine with antiemetic properties, but ondansetron is often preferred for chemotherapy-induced nausea and vomiting due to its efficacy and fewer side effects. Lorazepam (choice D) is a benzodiazepine used for anxiety and insomnia, not typically for managing nausea and vomiting in this context.

2. 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.

3. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?

• A. Excessive doxorubicin can result in myelosuppression.
• B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
• C. An excess amount of doxorubicin can lead to cardiomyopathy.
• D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.

Correct answer: C

Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.

4. When a client is prescribed hydrochlorothiazide, what adverse effect should they monitor for as instructed by the nurse?

• A. Hyponatremia
• B. Ototoxicity
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: A

Rationale: Hyponatremia is a critical adverse effect associated with hydrochlorothiazide use. This medication is a diuretic that can lead to excessive loss of sodium and water from the body, potentially causing low sodium levels and resulting in hyponatremia. Monitoring for signs and symptoms of hyponatremia, such as confusion, headache, weakness, and muscle cramps, is essential to prevent serious complications. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) and hyperkalemia (choice D) are also not typically associated with hydrochlorothiazide use.

5. A drug ending in the suffix (navir) is considered a ______.

• A. Antidepressant
• B. Protease inhibitor
• C. Beta antagonist
• D. H antagonist

Correct answer: B

Rationale: When a drug name ends in the suffix -navir, it indicates that the drug is a protease inhibitor. Protease inhibitors are commonly used in antiviral therapy to treat infections by inhibiting viral replication. Therefore, the correct answer is B: Protease inhibitor.

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