Nursing Elites

1. A client is receiving treatment with capecitabine. Which of the following findings should the nurse monitor?

• A. Hyperglycemia
• B. Hypocalcemia
• C. Neutropenia
• D. Bradycardia

Correct answer: C

Rationale: The nurse should monitor the client for neutropenia when receiving capecitabine, as it is a common adverse effect caused by bone marrow suppression. Neutropenia increases the risk of infection, making it essential for the nurse to closely monitor the client's white blood cell count and assess for signs of infection during treatment. Hyperglycemia (Choice A) is not typically associated with capecitabine. Hypocalcemia (Choice B) and bradycardia (Choice D) are not commonly linked to capecitabine use. Therefore, monitoring for neutropenia is the priority in this scenario.

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

• 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 who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

3. A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?

• A. aPTT of 90 seconds
• B. Platelet count of 150,000/mm³
• C. INR of 1.0
• D. Hgb of 15 g/dL

Correct answer: A

Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.

4. A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?

• A. Skin test for allergy to the medication
• B. ECG to rule out cardiac dysrhythmias
• C. Mantoux test to rule out exposure to tuberculosis
• D. Liver function tests to assess risk for medication toxicity

Correct answer: A

Rationale: Before starting Calcitonin-salmon, it is important to assess for any potential allergies as anaphylaxis can occur. A skin test is usually conducted to determine if the client is allergic to the medication. The nurse should also inquire about any previous allergies to fish, as Calcitonin-salmon is derived from salmon. Options B, C, and D are not necessary before initiating Calcitonin-salmon therapy. ECG is not directly related to this medication, Mantoux test is used to diagnose tuberculosis, and liver function tests are not specifically required before starting Calcitonin-salmon.

5. A client has a prescription for ceftriaxone. Which of the following information should the nurse include in the teaching?

• A. You may develop a cough while taking this medication.
• B. You should stop taking this medication if you develop a rash.
• C. This medication can be given orally.
• D. This medication may cause your urine to turn yellow.

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to discontinue ceftriaxone if a rash develops, as it could indicate an allergic reaction that needs to be reported to the healthcare provider for further evaluation and management. Choices A, C, and D are incorrect because cough development, oral administration, and yellow urine are not typically associated with ceftriaxone use and are not critical information that the nurse needs to emphasize in this scenario.

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