Nursing Elites

1. A client has a new prescription for Filgrastim to treat neutropenia. Which of the following statements should the nurse include?

• A. This medication will help increase your white blood cell count.
• B. This medication will help reduce your risk of infection.
• C. This medication will help improve your red blood cell count.
• D. This medication will help increase your platelet count.

Correct answer: A

Rationale: The correct statement the nurse should include is that 'This medication will help increase your white blood cell count.' Filgrastim is a medication used to stimulate the production of white blood cells, specifically neutrophils, to increase the white blood cell count. This increase in white blood cells helps reduce the risk of infections in clients with neutropenia. Choices B, C, and D are incorrect because Filgrastim specifically targets white blood cells, not red blood cells or platelets.

2. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

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

• A. Drink 2 liters of water daily.
• B. Avoid taking the medication on an empty stomach.
• C. Limit vitamin C intake while taking this medication.
• D. Take an iron supplement while on this medication.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol is to drink 2 liters of water daily. This recommendation aims to reduce the risk of kidney stones, a potential side effect associated with allopurinol use. Adequate hydration helps prevent the formation of uric acid crystals in the kidneys, which can lead to kidney stones. Therefore, encouraging increased water intake is essential in the management of clients taking allopurinol.

4. A client with angina asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?

• A. Aspirin
• B. Isosorbide
• C. Clopidogrel
• D. Atorvastatin

Correct answer: B

Rationale: Isosorbide is an organic nitrate used to manage angina. Concurrent use of sildenafil with organic nitrates, like isosorbide, is contraindicated due to the risk of fatal hypotension. It is essential for clients to avoid taking nitrate medications within 24 hours of using isosorbide to prevent serious complications.

5. 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.

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