Nursing Elites

1. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

• A. Platelet count
• B. Electrolyte levels
• C. Thyroid function
• D. Liver function

Correct answer: D

Rationale: The correct answer is D: Liver function. Gemfibrozil can lead to hepatotoxicity, making it crucial to monitor liver function tests. Monitoring platelet count (choice A) is not specifically indicated for gemfibrozil. Electrolyte levels (choice B) and thyroid function (choice C) are not directly affected by gemfibrozil, so they are not the primary laboratory tests to monitor in this case.

2. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

• A. Allergic response
• B. Superinfection
• C. Renal toxicity
• D. Hepatotoxicity

Correct answer: B

Rationale: Candidiasis is a type of superinfection that can occur when antibiotics, like tetracycline, disrupt the normal flora, allowing overgrowth of fungi. Option A, allergic response, is incorrect because candidiasis is not typically an allergic reaction. Option C, renal toxicity, and option D, hepatotoxicity, are incorrect as they refer to adverse effects on the kidneys and liver, respectively, which are not directly related to the development of candidiasis.

3. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

• A. Antiestrogenic
• B. Antimicrobial
• C. Androgenic
• D. Anti-inflammatory

Correct answer: A

Rationale: Tamoxifen is an antiestrogen medication used primarily in the treatment and prevention of breast cancer. It works by blocking the effects of estrogen in the breast tissue, thereby acting as an antiestrogenic agent. This makes choice A the correct answer. Choice B, antimicrobial, is incorrect as tamoxifen does not possess antimicrobial properties and is not used to treat infections. Choice C, androgenic, is incorrect as tamoxifen has antiestrogenic effects, not androgenic effects. Choice D, anti-inflammatory, is incorrect as tamoxifen's main therapeutic action is antiestrogenic rather than anti-inflammatory.

4. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?

• A. I know that blurred vision is something I will expect to happen while taking digoxin.
• B. I will measure my urine output each day and document it in my diary.
• C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
• D. I will eat fruits and vegetables that have high potassium content every day.

Correct answer: D

Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.

5. A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication?

• A. Blood pressure
• B. Temperature
• C. Blood glucose levels
• D. Total protein levels

Correct answer: A

Rationale: The correct answer is A: Blood pressure. Epoetin alfa can increase blood pressure, especially in clients with chronic kidney failure. Monitoring blood pressure before administration is crucial to prevent hypertension. Reviewing temperature, blood glucose levels, or total protein levels is not directly related to the potential side effect of increased blood pressure associated with epoetin alfa.

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