Nursing Elites

1. When teaching a client with cancer who has a prescription for methotrexate, which supplement should the nurse instruct the client to take?

• A. Folic acid
• B. Magnesium
• C. Vitamin D
• D. Iron

Correct answer: A

Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, so instructing the client to take folic acid helps reduce the risk of methotrexate toxicity by providing additional folic acid that the medication may deplete. Magnesium (choice B), Vitamin D (choice C), and Iron (choice D) are not the correct supplements to instruct the client to take with methotrexate.

2. A client has a new prescription for Furosemide. Which of the following instructions should be included by the nurse?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction to include when a client is prescribed Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects.

3. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

4. A healthcare professional is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the healthcare professional plan to take?

• A. Expel the air bubble from the prefilled syringe before injecting.
• B. Insert the needle completely into the client's tissue.
• C. Administer the injection in the client's thigh.
• D. Aspirate carefully after inserting the needle into the client's skin.

Correct answer: B

Rationale: Correct Answer: B. When administering enoxaparin, it is essential to insert the needle completely into the client's tissue to ensure a deep subcutaneous injection. This method helps in the appropriate delivery of the medication. Choice A is incorrect because expelling air bubbles is not necessary with subcutaneous injections and may lead to medication loss. Choice C is incorrect as enoxaparin is usually administered in the abdomen, not the thigh. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or bleeding.

5. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer subcutaneously in a large muscle mass to prevent injury.
• B. Ensure that the medication is kept at room temperature until just prior to administration.
• C. Invert vial gently to mix well before withdrawing dose.
• D. Discard vial after removing one dose of the medication.

Correct answer: D

Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.

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