Nursing Elites

1. A nurse is caring for a client who is receiving treatment with vincristine. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Neurotoxicity
• C. Neutropenia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for symptoms such as peripheral neuropathy, muscle weakness, and tingling sensations is crucial. Choices A, C, and D are incorrect because hyperkalemia, neutropenia, and bradycardia are not typically associated with vincristine therapy.

2. A healthcare professional is reviewing the medical history of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following findings should the healthcare professional report to the provider?

• A. Hemoglobin A1C of 7.5%
• B. Creatinine level of 1.2 mg/dL
• C. BUN level of 18 mg/dL
• D. Liver function tests showing AST of 50 units/L

Correct answer: D

Rationale: The correct answer is D. Elevated AST levels in liver function tests should be reported to the provider when a client is prescribed Metformin due to the potential risk of hepatotoxicity associated with the medication. Elevated Hemoglobin A1C (choice A), Creatinine level within normal range (choice B), and BUN level within normal range (choice C) are not directly concerning when initiating Metformin therapy.

3. A client is starting therapy with cisplatin. The healthcare provider should instruct the client to report which of the following adverse effects?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is tinnitus. Cisplatin can cause ototoxicity, which may manifest as tinnitus. Tinnitus should be reported promptly to the healthcare provider to prevent further hearing damage.

4. A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?

• A. Varicella vaccine
• B. Rubella vaccine
• C. Inactivated influenza vaccine
• D. Measles vaccine

Correct answer: C

Rationale: The correct answer is C, the inactivated influenza vaccine. During pregnancy, the Centers for Disease Control and Prevention (CDC) recommend the inactivated influenza vaccine as safe for pregnant individuals. This vaccination is crucial to protect both the pregnant person and their developing baby from influenza-related complications. It is essential to avoid live vaccines, such as varicella (chickenpox), rubella, and measles vaccines during pregnancy due to the theoretical risk of harm to the fetus. Choices A, B, and D are incorrect because live vaccines are generally contraindicated during pregnancy.

5. A patient has been taking hydrocodone, an opioid analgesic for their moderate pain, and they have taken more than the prescribed dose. What should you administer as the antidote if they experience toxicity?

• A. Naloxone
• B. N-acetylcysteine
• C. Atropine
• D. Digoxin immune Fab

Correct answer: A

Rationale: Naloxone is the specific antidote for opioid toxicity. It works by blocking the effects of opioids on the central nervous system, thereby reversing symptoms like respiratory depression and sedation. N-acetylcysteine is used for acetaminophen overdose, while atropine is indicated for certain types of poisonings. Digoxin immune Fab is used for digoxin toxicity. Therefore, in the case of opioid toxicity due to hydrocodone overdose, naloxone is the appropriate antidote.

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