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 client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?

• A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
• B. Leucovorin increases platelet production and prevents bleeding.
• C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
• D. Leucovorin protects healthy cells from Methotrexate's toxic effects.

Correct answer: D

Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment. Choices A, B, and C are incorrect because Leucovorin does not reduce the risk of a transfusion reaction from Methotrexate, increase platelet production, prevent bleeding, or potentiate the cytotoxic effects of Methotrexate. Instead, Leucovorin works by rescuing healthy cells from the toxic effects of Methotrexate.

3. A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Monitor your pulse before taking the medication.
• C. Expect to have an increased appetite.
• D. Discontinue the medication if you feel nauseated.

Correct answer: B

Rationale: When educating a client about Digoxin, it is crucial to instruct them to monitor their pulse before taking the medication. Digoxin can lead to bradycardia, so monitoring the pulse is essential to ensure it is not below 60 beats per minute before taking each dose. If the pulse is low, the client should hold the dose and seek guidance from their healthcare provider. Choices A, C, and D are incorrect. Taking Digoxin with food may affect its absorption, Digoxin is not known to increase appetite, and feeling nauseated does not necessarily indicate the need to discontinue the medication.

4. A client is taking Furosemide for heart failure. Which of the following laboratory tests should the nurse monitor to assess for an adverse effect of this medication?

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

Correct answer: A

Rationale: Furosemide, a loop diuretic commonly used in heart failure, can cause hypokalemia (low potassium levels) as a side effect. Monitoring serum potassium levels is crucial to detect and prevent complications associated with low potassium levels, such as cardiac arrhythmias. Therefore, the nurse should prioritize assessing the client's serum potassium levels regularly while on Furosemide. Serum calcium, sodium, and magnesium levels are not typically affected by Furosemide and are not the primary focus of monitoring for adverse effects of this medication.

5. 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.

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