Nursing Elites

1. When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?

• A. Assessing the injection site for itching and edema
• B. Monitoring white blood cell counts and platelet counts
• C. Evaluating for fatigue and joint pain in the client
• D. Checking for a metallic taste in the mouth and loss of appetite

Correct answer: B

Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.

2. The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?

• A. Administer the medication within 60 minutes before the morning and evening meal.
• B. Withhold the medication and question the prescription with the healthcare provider.
• C. Monitor the client for gastrointestinal side effects after administration of the medication.
• D. Withdraw the insulin from the Penlet into an insulin syringe to prepare for administration.

Correct answer: B

Rationale: Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Choice A is incorrect because exenatide should not be administered to a client with type 1 diabetes mellitus who takes insulin. Choice C is not the most appropriate initial action when the prescription is not suitable for the client. Choice D is unrelated to the administration of exenatide. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.

3. A client is receiving instructions from a healthcare provider about intranasal desmopressin acetate (DDAVP). The healthcare provider explains that which of the following is a side effect of the medication?

• A. Headache
• B. Vulval pain
• C. Runny nose
• D. Flushed skin

Correct answer: C

Rationale: Intranasal desmopressin can cause a runny or stuffy nose as a side effect due to its mode of administration through the nasal passages.

4. Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?

• A. Potassium level
• B. Creatinine level
• C. Cholesterol level
• D. Blood urea nitrogen

Correct answer: A

Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.

5. A client taking ethambutol (Myambutol) understands the instructions provided by the nurse if the client states that he or she will immediately report:

• A. Impaired sense of hearing
• B. Problems with visual acuity
• C. Gastrointestinal (GI) side effects
• D. Orange-red discoloration of body secretions

Correct answer: B

Rationale: The correct answer is B: Problems with visual acuity. Ethambutol is known to cause optic neuritis, leading to a decrease in visual acuity and color discrimination. Therefore, any visual changes should be reported promptly to prevent further complications. Choices A, C, and D are incorrect because ethambutol does not typically cause impaired sense of hearing, gastrointestinal side effects, or orange-red discoloration of body secretions. It is crucial for clients taking ethambutol to be aware of potential visual disturbances and report them promptly to healthcare providers.

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