Nursing Elites

1. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

2. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?

• A. Excessive doxorubicin can result in myelosuppression.
• B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
• C. An excess amount of doxorubicin can lead to cardiomyopathy.
• D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.

Correct answer: C

Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.

3. A healthcare provider is caring for a client who has a new prescription for Clonidine. Which of the following adverse effects should the healthcare provider monitor?

• A. Drowsiness
• B. Dry mouth
• C. Weight gain
• D. Insomnia

Correct answer: B

Rationale: The correct answer is B: Dry mouth. Dry mouth is a common adverse effect of Clonidine. Clonidine can cause a reduction in salivary flow, leading to dry mouth. This symptom can be managed by increasing fluid intake or using sugar-free gum or candy to stimulate saliva production. Choices A, C, and D are incorrect. While drowsiness and insomnia are potential side effects of Clonidine, dry mouth is more commonly reported. Weight gain is not typically associated with Clonidine use.

4. A client in a critical care unit is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?

• A. Prone
• B. On the nonoperative side
• C. Sims'
• D. Semi-Fowler's

Correct answer: D

Rationale: After a pneumonectomy, positioning the client in a semi-Fowler's position is crucial for optimal ventilation. This position helps improve lung expansion on the remaining side, facilitating better oxygenation and preventing complications like atelectasis. Placing the client prone, on the nonoperative side, or in Sims' position would not provide the same respiratory benefits post-pneumonectomy.

5. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)

• A. Expect therapeutic effects in 1-3 weeks.
• B. Discontinue the medication gradually under healthcare provider supervision.
• C. Change positions slowly to minimize dizziness.
• D. Increase dietary fiber intake to prevent constipation.

Correct answer: C

Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.

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