Nursing Elites

1. The client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which of the following would indicate to the nurse that the client is experiencing a toxic effect related to the medication?

• A. Fever
• B. Diarrhea
• C. Complaints of nausea and vomiting
• D. Crackles on auscultation of the lungs

Correct answer: D

Rationale: Crackles on auscultation of the lungs would indicate a toxic effect related to daunorubicin, known to cause cardiotoxicity. Cardiotoxicity can manifest as heart failure, abnormal ECG findings, or cardiomyopathy. It is crucial for the nurse to monitor for signs of cardiotoxicity to ensure timely intervention and prevent further complications. Fever, diarrhea, and complaints of nausea and vomiting are common side effects of daunorubicin but do not specifically indicate a toxic effect like cardiotoxicity.

2. A client with hypertension is prescribed losartan (Cozaar). Which instruction should the nurse include in the teaching plan?

• A. Avoid foods high in potassium.
• B. Take the medication with grapefruit juice.
• C. Monitor blood pressure weekly.
• D. Report any swelling of the lips or face.

Correct answer: D

Rationale: The correct instruction for a client prescribed losartan (Cozaar) is to report any swelling of the lips or face. Losartan can cause angioedema, which is a serious side effect that requires immediate medical attention. Clients do not need to avoid potassium-rich foods unless specifically instructed by their healthcare provider. Taking the medication with grapefruit juice is not recommended as it can interact with certain medications. Additionally, monitoring blood pressure regularly is important, but it should not be limited to a weekly basis; blood pressure should be monitored as per the healthcare provider's recommendation.

3. A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?

• A. Apply the patch to a hairless area of skin.
• B. Leave the patch on for 24 hours.
• C. Apply the patch at the same time each day.
• D. You can keep the patch on while taking a shower.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching plan is to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day. This consistency helps maintain steady blood levels of the medication. While it is important to apply the patch to a hairless area of the skin for proper absorption, it does not necessarily have to be left on for 24 hours; typically, it is worn for 12-14 hours to allow for a nitrate-free period and reduce tolerance. Additionally, the patch can generally be kept on while taking a shower, as water exposure does not typically affect its efficacy.

4. A client is prescribed alendronate (Fosamax) for the treatment of osteoporosis. Which instruction should the nurse provide to the client?

• A. Take the medication at bedtime.
• B. Take the medication with a full glass of water.
• C. Lie down for 30 minutes after taking the medication.
• D. Take the medication with food to avoid gastrointestinal upset.

Correct answer: B

Rationale: The correct instruction for a client prescribed alendronate (Fosamax) for osteoporosis is to take the medication with a full glass of water first thing in the morning. It should be taken at least 30 minutes before any food, beverage, or other medication. The client should also remain upright for at least 30 minutes after taking the medication to prevent esophageal irritation. Taking alendronate at bedtime or with food is not recommended as it may reduce its absorption and effectiveness.

5. The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?

• A. Diarrhea
• B. Hair loss
• C. Chest pain
• D. Numbness and tingling in the fingers and toes

Correct answer: D

Rationale: The correct answer is D: Numbness and tingling in the fingers and toes. Vincristine is known to cause peripheral neuropathy as a side effect, resulting in numbness and tingling in the fingers and toes. Diarrhea, hair loss, and chest pain are not typically associated with vincristine use.

Similar Questions