Nursing Elites

1. A client is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor?

• A. Leukocytosis
• B. Hypertension
• C. Hyperkalemia
• D. Fever

Correct answer: B

Rationale: The nurse should monitor the client for hypertension when receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which can lead to increased blood pressure. Monitoring blood pressure is crucial to detect and manage hypertension promptly. Leukocytosis refers to an increased white blood cell count and is not directly related to epoetin alfa treatment. Hyperkalemia is an elevated potassium level, which is not a common adverse effect of epoetin alfa. Fever is not a typical finding associated with epoetin alfa therapy.

2. When teaching a client with a new prescription for Furosemide, which instruction should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction for a client with a new prescription for Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects. Choices A, B, and D are incorrect. Taking Furosemide at bedtime (Choice A) is not necessary as it can be taken at any time of the day. Avoiding foods high in potassium (Choice B) is more relevant for clients taking potassium-sparing diuretics. Taking Furosemide with meals (Choice D) may lead to increased diuretic effects and frequent urination.

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

• A. Take the medication with a full glass of water.
• B. Avoid taking the medication with food.
• C. Discontinue the medication if diarrhea occurs.
• D. Expect to have increased appetite while taking this medication.

Correct answer: A

Rationale: The correct instruction for a client taking Clindamycin is to take the medication with a full glass of water. Clindamycin can cause esophageal irritation, so taking it with a full glass of water helps minimize this risk. Avoiding taking the medication with food is not necessary. If diarrhea occurs, clients should not discontinue the medication without consulting their healthcare provider. Clindamycin is not known to cause increased appetite.

4. A healthcare professional reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once daily. The healthcare professional should identify this as which of the following types of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates that the medication is to be administered on a regular schedule, typically daily, without a specified termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily is to be given regularly until the healthcare provider decides to discontinue it. This type of prescription is common for medications that are part of the client's ongoing treatment regimen. The other choices are incorrect: 'Single' does not provide information about the frequency or duration of administration, 'Stat' indicates an urgent, one-time administration, and 'Standing' refers to a prescription that is automatically renewed without the need for a new order for each administration.

5. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

• A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
• B. I will call the provider to get a prescription for discontinuing the IV heparin today.
• C. Both heparin and warfarin work together to dissolve the clots.
• D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.

Correct answer: A

Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.

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