Nursing Elites

1. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?

• A. BUN
• B. Creatinine
• C. Hemoglobin
• D. White blood cell count

Correct answer: B

Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.

2. A client with Graves' disease is being taught about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

• A. Propranolol helps increase blood flow to my thyroid gland.
• B. Propranolol is used to prevent excess glucose in my blood.
• C. Propranolol will decrease my tremors and fast heart rate.
• D. Propranolol promotes a decrease in thyroid hormone in my body.

Correct answer: C

Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that helps decrease heart rate and control tremors in individuals with Graves' disease. It does not increase blood flow to the thyroid gland (choice A), prevent excess glucose in the blood (choice B), or directly decrease thyroid hormone levels in the body (choice D). Propranolol's primary role in Graves' disease is to alleviate symptoms like tremors and fast heart rate by blocking the effects of excessive thyroid hormone, rather than reducing the actual levels of thyroid hormone in the body.

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

• A. Expect orange discoloration of urine and skin.
• B. Increase your intake of high-sodium foods.
• C. Take the medication with a full glass of milk.
• D. Expect your stools to be black and tarry.

Correct answer: A

Rationale: The correct instruction to include when teaching a client with a new prescription for Sulfasalazine is to expect orange discoloration of urine and skin. Sulfasalazine can cause this harmless side effect, which does not necessitate discontinuation of the medication. It is crucial for the nurse to educate the client about this expected outcome to prevent unnecessary concern or discontinuation of the medication. Choices B, C, and D are incorrect. Increasing intake of high-sodium foods is not recommended with Sulfasalazine, as it can worsen certain side effects. Taking the medication with a full glass of milk is not necessary for Sulfasalazine administration. Expecting stools to be black and tarry is not an expected side effect of Sulfasalazine.

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

• A. Monitor for signs of bleeding.
• B. Avoid taking the medication with food.
• C. Expect to have increased urination.
• D. Take the medication with an antacid.

Correct answer: A

Rationale: Corrected Rationale: Clopidogrel is an antiplatelet medication that increases the risk of bleeding. The client should monitor for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stool, and report them promptly to their healthcare provider for further evaluation and management. Choice B is incorrect because Clopidogrel can be taken with or without food. Choice C is incorrect as increased urination is not a common side effect of Clopidogrel. Choice D is incorrect as taking Clopidogrel with an antacid may reduce its effectiveness.

5. A client is taking Epoetin Alfa for anemia. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?

• A. White blood cell count
• B. Platelet count
• C. Hematocrit
• D. Serum potassium level

Correct answer: C

Rationale: The nurse should monitor the hematocrit level to evaluate the effectiveness of Epoetin Alfa therapy. Epoetin Alfa stimulates red blood cell production, leading to an increase in hematocrit levels. Monitoring the hematocrit helps assess the response to therapy and ensures that the medication is effectively addressing the anemia. White blood cell count and platelet count are not directly affected by Epoetin Alfa therapy. Serum potassium level monitoring is important for other medications that may impact potassium levels but is not specifically relevant to assessing the effectiveness of Epoetin Alfa in treating anemia.

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