Nursing Elites

1. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer intravenously to prevent injury.
• B. Ensure that the medication is kept refrigerated until just prior to administration.
• C. Do not shake the vial; gently invert it to mix before withdrawing the dose.
• D. Discard the vial after removing one dose of the medication.

Correct answer: D

Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing. It is crucial not to shake the vial but gently invert it to mix the medication before withdrawing the appropriate dose. Refrigeration is not required for Filgrastim; it should be stored at room temperature until just before administration. Choice A is incorrect because Filgrastim is typically administered subcutaneously, not intravenously. Choice B is incorrect as the medication should be stored at room temperature, not refrigerated, until administration. Choice C is incorrect as shaking the vial is not recommended for Filgrastim.

2. A toddler is being admitted to the hospital after an Acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this patient?

• A. Acetylcysteine
• B. Pegfilgrastim
• C. Misoprostol
• D. Naltrexone

Correct answer: A

Rationale: In cases of Acetaminophen overdose, acetylcysteine is the antidote of choice. Acetylcysteine helps prevent liver damage by replenishing depleted glutathione levels, which is essential for detoxifying acetaminophen metabolites. Pegfilgrastim is a medication used to stimulate white blood cell production, Misoprostol is a medication for preventing stomach ulcers, and Naltrexone is used for treating opioid addiction and alcoholism, but none of these are indicated for Acetaminophen overdose.

3. When a client is prescribed hydrochlorothiazide, what adverse effect should they monitor for as instructed by the nurse?

• A. Hyponatremia
• B. Ototoxicity
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: A

Rationale: Hyponatremia is a critical adverse effect associated with hydrochlorothiazide use. This medication is a diuretic that can lead to excessive loss of sodium and water from the body, potentially causing low sodium levels and resulting in hyponatremia. Monitoring for signs and symptoms of hyponatremia, such as confusion, headache, weakness, and muscle cramps, is essential to prevent serious complications. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) and hyperkalemia (choice D) are also not typically associated with hydrochlorothiazide use.

4. A client has a new prescription for erythromycin. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should take this medication with a full glass of water.
• B. I should avoid direct sunlight while taking this medication.
• C. I will take this medication on an empty stomach.
• D. I should take an antacid 30 minutes before taking this medication.

Correct answer: C

Rationale: The correct answer is C. Erythromycin should be taken on an empty stomach with a full glass of water to increase absorption. Taking it with a full glass of water (Choice A) is incorrect. Avoiding direct sunlight (Choice B) is not related to erythromycin use. Taking an antacid before the medication (Choice D) can interfere with its absorption.

5. A healthcare provider is caring for a client who has a new prescription for Epoetin Alfa. Which of the following laboratory values should the healthcare provider monitor?

• A. WBC count.
• B. Platelet count.
• C. Hemoglobin.
• D. Serum potassium.

Correct answer: C

Rationale: Epoetin alfa is a medication that stimulates red blood cell production, so hemoglobin levels should be monitored to assess the effectiveness of the drug. Monitoring hemoglobin levels helps evaluate the response to Epoetin Alfa treatment and ensures that the client's anemia is being appropriately managed.

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