Nursing Elites

1. A client has a new prescription for combination oral NRTIs for the treatment of HIV. Which of the following statements should the nurse include in discharge teaching?

• A. These medications work by inhibiting enzymes to prevent HIV replication.
• B. These medications work by preventing protein synthesis within the HIV cell.
• C. These medications work by weakening the cell wall of the HIV virus.
• D. These medications work by blocking HIV entry into cells.

Correct answer: A

Rationale: The correct answer is A. NRTI antiretroviral medications inhibit the enzyme reverse transcriptase, which is essential for HIV replication. By blocking this enzyme, the medications prevent the virus from replicating and spreading. This mechanism of action helps to control the progression of HIV infection in the body. Choices B, C, and D are incorrect because NRTIs do not work by preventing protein synthesis, weakening the cell wall of the virus, or blocking HIV entry into cells. These mechanisms are associated with different classes of antiretroviral medications used in HIV treatment.

2. A patient is receiving IV heparin for a deep-vein thrombosis and begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: Protamine is the antidote for heparin, as it reverses its anticoagulant effects. In cases of heparin overdose or if there is excessive bleeding, administering protamine can quickly neutralize the effects of heparin, helping to prevent further bleeding complications.

3. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.

4. When caring for a school-age child with a new prescription for Atomoxetine, the nurse should monitor the client for which of the following adverse effects of this medication?

• A. Kidney toxicity
• B. Liver damage
• C. Seizure activity
• D. Adrenal insufficiency

Correct answer: B

Rationale: The correct answer is B: Liver damage. Atomoxetine can lead to liver damage as an adverse effect. Symptoms of liver damage include jaundice, upper abdominal tenderness, dark urine, and elevated liver enzymes. Monitoring for these signs is crucial when a child is on this medication. Choices A, C, and D are incorrect because Atomoxetine is not known to cause kidney toxicity, seizure activity, or adrenal insufficiency as primary adverse effects.

5. A client with breast cancer is being taught by a nurse about the adverse effects of chemotherapy. Which of the following statements should the nurse include?

• A. You should use a soft-bristled toothbrush to prevent bleeding.
• B. You should avoid contact with individuals who recently received live virus vaccines.
• C. You should take aspirin for minor aches and pains.
• D. You should consume a diet low in protein to reduce the risk of renal damage.

Correct answer: A

Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia. Chemotherapy can decrease platelet counts, leading to an increased risk of bleeding. Using a soft-bristled toothbrush can help prevent gum bleeding and oral trauma. Choices B, C, and D are incorrect. Avoiding contact with individuals who recently received live virus vaccines is crucial to prevent infections in immunocompromised clients. Aspirin should be avoided due to its blood-thinning effects that can increase the risk of bleeding. A diet low in protein is not recommended as cancer clients often require adequate protein intake for healing and recovery.

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