Nursing Elites

1. A patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment?

• A. AST
• B. C-reactive protein
• C. CBC
• D. ALT

Correct answer: A

Rationale: The correct answer is AST. Epoetin alfa is a medication used to treat anemia associated with chronic renal failure. During treatment with epoetin alfa, it is crucial to monitor AST levels as this medication can potentially lead to liver toxicity. Assessing AST levels before and throughout treatment helps in early detection of any liver abnormalities. C-reactive protein is not specifically related to the use of epoetin alfa in renal failure. While CBC (Complete Blood Count) monitoring is essential during treatment with epoetin alfa to evaluate the response to therapy, prioritizing AST assessment is more critical due to the potential for liver toxicity. ALT monitoring is also important but AST is prioritized in this scenario.

2. The healthcare provider is caring for a client with an altered level of consciousness and needs to assess the withdrawal reflex. Which action should the healthcare provider perform?

• A. Apply a painful stimulus to see if the client pulls away.
• B. Check for pupil response to light.
• C. Assess the client's response to verbal commands.
• D. Observe the client's reaction to a cold stimulus.

Correct answer: A

Rationale: The withdrawal reflex is assessed by applying a painful stimulus and observing if the client pulls away. This response indicates a functioning reflex arc. Choices B, C, and D are incorrect as they do not involve testing the withdrawal reflex specifically. Checking for pupil response to light assesses the pupillary reflex, assessing the client's response to verbal commands evaluates their cognitive function, and observing the client's reaction to a cold stimulus tests for a different type of sensory response.

3. A patient is prescribed medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse teach the patient about the proper use of this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Avoid prolonged sun exposure while taking this medication.
• C. Discontinue the medication if side effects occur.
• D. Apply the medication once a week.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Consistency in timing helps regulate the hormone levels in the body, ensuring the medication's optimal benefit. Choice B is incorrect as there is no specific need to avoid sun exposure with this medication. Choice C is incorrect because discontinuing the medication without consulting the healthcare provider may not be safe. Choice D is incorrect as medroxyprogesterone acetate is typically taken orally and not applied topically once a week.

4. A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect if the medication is effective?

• A. Decreased urinary frequency and urgency
• B. Increased prostate size
• C. Increased blood pressure
• D. Decreased blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is used to reduce the size of the prostate gland in patients with BPH. As a result, when the medication is effective, the patient should experience a decrease in urinary frequency and urgency. Choices B, C, and D are incorrect. Choice B is inaccurate because finasteride aims to reduce prostate size, not increase it. Choices C and D are unrelated to the action of finasteride in treating BPH.

5. Thrombocytopenia is which disorder below?

• A. Increased blood coagulation
• B. Increased platelet production
• C. Increased number of infections
• D. Decreased platelet production

Correct answer: D

Rationale: Thrombocytopenia is a disorder characterized by a decreased platelet count or decreased platelet production, which affects blood clotting. Choice A, 'Increased blood coagulation,' is incorrect as thrombocytopenia is associated with decreased platelets, leading to impaired clotting. Choice B, 'Increased platelet production,' is incorrect as thrombocytopenia is characterized by a decrease in platelet production. Choice C, 'Increased number of infections,' is unrelated to thrombocytopenia, which primarily involves low platelet levels.

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