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Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing.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 client has a new prescription for Cyclobenzaprine to treat muscle spasms. Which of the following instructions should the nurse include in the teaching?

• A. Avoid driving or operating heavy machinery while taking this medication.
• B. Take this medication on an empty stomach for best results.
• C. Take this medication only when experiencing muscle pain.
• D. Increase your intake of potassium-rich foods while taking this medication.

Correct answer: A

Rationale: The correct instruction that the nurse should include in the teaching for a client prescribed Cyclobenzaprine is to avoid driving or operating heavy machinery while taking this medication. Cyclobenzaprine can cause drowsiness, so it is important to advise clients to avoid activities that require alertness and coordination to prevent accidents or injuries. Choice B is incorrect because Cyclobenzaprine can be taken with or without food. Choice C is incorrect because Cyclobenzaprine is typically taken regularly as prescribed, not just when experiencing muscle pain. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Cyclobenzaprine.

3. A healthcare professional is preparing to administer Enoxaparin to a client. Which of the following actions should the healthcare professional take?

• A. Administer the medication orally.
• B. Massage the injection site after administration.
• C. Insert the needle at a 45- to 90-degree angle.
• D. Aspirate before injecting the medication.

Correct answer: C

Rationale: Enoxaparin should be administered subcutaneously at a 45- to 90-degree angle. This angle ensures proper delivery of the medication. Massaging the injection site should be avoided to prevent bruising and possible tissue damage. Aspiration is not required for subcutaneous injections like Enoxaparin. Therefore, the correct action for administering Enoxaparin is to insert the needle at a 45- to 90-degree angle.

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

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin sublingual tablets involves taking one tablet at the onset of chest pain and repeating every 5 minutes for up to three doses. This protocol helps in managing angina episodes effectively. Choice A suggests taking a tablet every 15 minutes until pain relief, which may delay appropriate intervention. Choice C, taking a tablet at bedtime, is not suitable for immediate relief during angina attacks. Choice D, taking a tablet on an empty stomach, is unrelated to the correct administration of Nitroglycerin sublingual tablets.

5. A client is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects?

• A. Increased TSH level
• B. Decreased ALT level
• C. Hypoglycemia
• D. Hyperlipidemia

Correct answer: D

Rationale: Hyperlipidemia, characterized by increased cholesterol and triglyceride levels, can occur as an adverse effect of Ritonavir. Monitoring lipid levels is essential to detect and manage this potential side effect in clients taking this medication for HIV infection.

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