Nursing Elites

1. 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.

2. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following herbal supplements should the nurse instruct the client to avoid?

• A. St. John's wort
• B. Echinacea
• C. Garlic
• D. Ginseng

Correct answer: A

Rationale: St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism pathways, potentially leading to decreased anticoagulant effects. Therefore, clients on Warfarin therapy should avoid St. John's wort. While echinacea, garlic, and ginseng are also herbal supplements that can interact with Warfarin, St. John's wort is particularly known for its significant impact on Warfarin metabolism. Echinacea may increase the risk of bleeding when taken with Warfarin, garlic may potentiate the anticoagulant effects of Warfarin, and ginseng may also increase the risk of bleeding. However, St. John's wort is the most crucial to avoid due to its significant impact on Warfarin metabolism.

3. A client with breast cancer is receiving cyclophosphamide. What finding should the nurse monitor for?

• A. Hypertension
• B. Hyperglycemia
• C. Ototoxicity
• D. Hemorrhagic cystitis

Correct answer: D

Rationale: When a client is receiving cyclophosphamide, the nurse should monitor for hemorrhagic cystitis, a severe adverse effect caused by bladder irritation. It is essential to watch for signs such as hematuria, dysuria, and urinary frequency, and promptly intervene to prevent further complications. Hypertension (Choice A) is not typically associated with cyclophosphamide use. Hyperglycemia (Choice B) is not a common side effect of cyclophosphamide. Ototoxicity (Choice C) is more commonly associated with medications like aminoglycoside antibiotics or high-dose aspirin.

4. Which of the following is not a side effect of Sympathoplegics (Clonidine)?

• A. Hypertension
• B. Difficulty breathing
• C. Dry oral cavity
• D. Lethargic behavior

Correct answer: A

Rationale: The correct answer is A. Clonidine, a Sympathoplegic, typically causes hypotension rather than hypertension. The other side effects associated with Clonidine include dry oral cavity, lethargic behavior, and difficulty breathing, making them incorrect choices in this context.

5. Which of the following is not directly related to the drug toxicity of Ibuprofen?

• A. Nausea
• B. Renal dysfunction
• C. Anemia
• D. Muscle wasting

Correct answer: D

Rationale: Ibuprofen is known to cause adverse effects such as nausea, renal dysfunction, and anemia. However, muscle wasting is not a common toxicity associated with Ibuprofen use. Therefore, the correct answer is D.

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