Nursing Elites

1. A healthcare professional is reviewing the medical record of a client with a new prescription for Epoetin Alfa. Which of the following findings should the professional report to the provider?

• A. The client has a history of hypertension.
• B. The client has a hemoglobin level of 10 g/dL.
• C. The client has a history of chronic kidney disease.
• D. The client has a blood pressure of 140/90 mm Hg.

Correct answer: C

Rationale: The correct answer is C. Chronic kidney disease is a contraindication for the use of Epoetin Alfa because it can worsen hypertension, increase the risk of cardiovascular events, and lead to adverse outcomes. Epoetin Alfa is used to treat anemia by stimulating red blood cell production, but in the presence of chronic kidney disease, it can exacerbate hypertension and contribute to cardiovascular complications. Choices A, B, and D are not directly related to the contraindication of Epoetin Alfa in the presence of chronic kidney disease.

2. When providing teaching to a client starting therapy with trastuzumab, which finding should the nurse instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a serious adverse effect of trastuzumab. Monitoring and early reporting of respiratory symptoms like dyspnea are essential to prevent further complications and ensure timely intervention. Choices B, C, and D are incorrect because constipation, tinnitus, and dry mouth are not typically associated with trastuzumab therapy and are not priority symptoms that require immediate reporting for this specific medication.

3. Which of the following is not a side effect of the cholinoreceptor blocker (Atropine)?

• A. Increased pulse
• B. Diarrhea
• C. Constipation
• D. Mydriasis

Correct answer: B

Rationale: Atropine, an anticholinergic drug, commonly causes side effects like increased pulse, mydriasis (dilated pupils), and constipation due to its inhibitory effect on the parasympathetic nervous system. Diarrhea is not typically a side effect of Atropine, making it the correct answer.

4. During an admission assessment for a client with severe Aspirin toxicity, what finding should the nurse expect?

• A. Body temperature 35°C (95°F)
• B. Lung crackles
• C. Cool, dry skin
• D. Respiratory depression

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression can occur due to increasing respiratory acidosis. Aspirin toxicity leads to metabolic acidosis, stimulating the respiratory center in the brain to increase the respiratory rate initially. However, as the toxicity worsens, respiratory muscle fatigue and depression can occur, resulting in respiratory depression. This can lead to hypoxia, respiratory failure, and ultimately, respiratory arrest.

5. During an assessment, a male client who has recently started taking Haloperidol is displaying certain symptoms. Which of the following findings should the nurse prioritize in reporting to the provider?

• A. Shuffling gait
• B. Neck spasms
• C. Drowsiness
• D. Impotence

Correct answer: B

Rationale: Neck spasms are indicative of acute dystonia, a serious side effect of Haloperidol that requires urgent intervention. Immediate reporting to the provider is crucial to address this potentially harmful condition and ensure the client's safety. Shuffling gait, drowsiness, and impotence are important to monitor but do not pose the same level of immediate risk as acute dystonia. Acute dystonia can lead to serious complications if not promptly treated, making it the priority in this scenario.

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