Nursing Elites

1. While caring for a client receiving IV heparin, which of the following findings should the nurse identify as an adverse effect of this medication?

• A. Hypertension
• B. Hyperglycemia
• C. Thrombocytopenia
• D. Leukopenia

Correct answer: C

Rationale: Thrombocytopenia, a decrease in platelet count, is a known adverse effect associated with heparin therapy. It can lead to an increased risk of bleeding and should be closely monitored during treatment. Choices A, B, and D are incorrect. Hypertension is not typically associated with heparin use; hyperglycemia is not a common adverse effect of heparin; leukopenia is not a primary side effect of heparin therapy.

2. A client with chronic renal disease is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

• A. The leukocyte count
• B. The platelet count
• C. The hematocrit (Hct)
• D. The erythrocyte sedimentation rate (ESR)

Correct answer: C

Rationale: The correct answer is C: The hematocrit (Hct). Monitoring the hematocrit is essential to assess the therapeutic effect of epoetin alfa because this medication stimulates red blood cell production in clients with chronic renal disease. The leukocyte count (choice A) and platelet count (choice B) are not directly affected by epoetin alfa therapy. The erythrocyte sedimentation rate (ESR) (choice D) is a non-specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa.

3. A client has a new prescription for Prednisone. Which of the following instructions should be included?

• A. Increase your intake of vitamin D.
• B. Take this medication on an empty stomach.
• C. Avoid drinking grapefruit juice.
• D. Take this medication every other day.

Correct answer: A

Rationale: When a client is prescribed Prednisone, it is important to increase the intake of vitamin D to help mitigate the risk of bone loss associated with the medication. Vitamin D aids in calcium absorption, supporting bone health in individuals taking Prednisone.

4. 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.

5. A healthcare provider is completing a client's medical history. The client takes Simvastatin. The healthcare provider should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?

• A. History of severe constipation
• B. History of hypertension
• C. Active hepatitis C
• D. Type 2 diabetes mellitus

Correct answer: C

Rationale: Ezetimibe is contraindicated in patients with active moderate-to-severe liver disorders, such as active hepatitis C, especially when they are already taking a statin like simvastatin. This combination can increase the risk of liver problems and is not recommended due to the potential for further liver damage. Choices A, B, and D are not directly contraindications for adding Ezetimibe to the client's medications.

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