Nursing Elites

1. A client is starting therapy with paclitaxel. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bradycardia
• B. Diarrhea
• C. Neutropenia
• D. Urinary retention

Correct answer: C

Rationale: Neutropenia is a common adverse effect of paclitaxel due to bone marrow suppression. Clients should be instructed to monitor for signs of infection and report any symptoms such as fever, chills, or sore throat immediately to their healthcare provider.

2. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.

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

• A. Take this medication at bedtime.
• B. Increase your fluid intake.
• C. Avoid foods high in calcium.
• D. Take this medication with meals.

Correct answer: B

Rationale: Allopurinol can cause kidney stones due to the formation of uric acid crystals, so it is crucial for the client to increase their fluid intake. Adequate hydration helps to prevent the formation of kidney stones by diluting the urine and promoting the excretion of uric acid. Therefore, advising the client to increase their fluid intake is essential in preventing this adverse effect while taking Allopurinol.

4. A client is to receive Tetracaine before a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

• A. Keep the client NPO until the pharyngeal response returns.
• B. Monitor the insertion site for a hematoma.
• C. Palpate the bladder to detect urinary retention.
• D. Maintain the client on bed rest for 12 hours following the procedure.

Correct answer: A

Rationale: The correct action for the nurse to include in the plan of care is to keep the client NPO until the pharyngeal response returns. Tetracaine can affect the gag reflex, so it is important to prevent aspiration by maintaining the client NPO until the pharyngeal response is normal, which typically takes about 1 hour. Monitoring for the return of the gag reflex is crucial to prevent complications from aspiration during the first oral intake after the procedure. Choices B, C, and D are incorrect because they are not directly related to the effects of Tetracaine or the bronchoscopy procedure.

5. A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included in the teaching?

• A. Take the medication with a full glass of water after rising in the morning.
• B. Lie down for 30 minutes after taking the medication.
• C. Take the medication with a meal to reduce gastric irritation.
• D. Crush the tablet and mix it with applesauce if difficulty swallowing.

Correct answer: A

Rationale: The correct instruction for taking alendronate is to take it with a full glass of water after rising in the morning to prevent esophageal irritation. It is important to remain upright for at least 30 minutes after taking the medication to reduce the risk of esophageal irritation and ensure proper absorption. Taking the medication with a meal or crushing the tablet are not recommended instructions for alendronate administration. Choice A is the correct answer as it aligns with the proper administration guidelines for alendronate.

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