Nursing Elites

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

• A. Take this medication with food.
• B. Avoid taking aspirin while on this medication.
• C. Avoid eating foods high in potassium.
• D. Take this medication at bedtime.

Correct answer: B

Rationale: The correct answer is B: 'Avoid taking aspirin while on this medication.' Clopidogrel is an antiplatelet medication that can increase the risk of bleeding. Aspirin and other NSAIDs also affect platelet function and can further increase the risk of bleeding when combined with Clopidogrel. Therefore, it is important for the client to avoid taking aspirin while on this medication to reduce the risk of excessive bleeding. Choices A, C, and D are incorrect because there is no specific requirement to take Clopidogrel with food, avoid foods high in potassium, or take it at bedtime. The key instruction here is to avoid aspirin to prevent potential bleeding complications.

2. A client who is receiving combination chemotherapy is exhibiting a temperature of 38.1°C (100.6°F). Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients undergoing chemotherapy due to the heightened risk of sepsis in immunocompromised individuals. Immediate assessment and intervention are crucial to prevent severe complications. Dry oral mucous membranes, nausea and vomiting, and anorexia are common side effects of chemotherapy but are not specific indicators of an oncologic emergency like a fever in this setting.

3. A client has a prescription for long-term use of oral prednisone for the treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Oral prednisone can lead to weight gain and fluid retention due to its sodium and water retention effects. Monitoring weight changes is crucial to identify and manage this adverse effect. Choices B, C, and D are incorrect because oral prednisone is not typically associated with nervousness, bradycardia, or constipation as common adverse effects. Therefore, the nurse should primarily focus on monitoring weight gain in clients prescribed long-term oral prednisone therapy.

4. A client is prescribed Diltiazem. Which of the following findings should the nurse monitor?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperkalemia

Correct answer: B

Rationale: Diltiazem is a calcium channel blocker that can cause bradycardia as an adverse effect due to its negative chronotropic properties, slowing down the heart rate. Therefore, the nurse should monitor the client for signs of bradycardia by regularly assessing the heart rate to prevent potential complications. Monitoring for tachycardia (choice A) is incorrect as diltiazem typically does not cause tachycardia. Hypertension (choice C) is not a typical finding to monitor for with diltiazem use. Hyperkalemia (choice D) is not directly associated with diltiazem administration.

5. A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?

• A. Apply the patch to a hairless area of the body.
• B. Remove the patch every 12 hours.
• C. Massage the patch after applying it.
• D. Place the patch over a hairless area of the body.

Correct answer: D

Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.

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