Nursing Elites

1. The client with breast cancer is receiving cyclophosphamide (Neosar). The nurse is reinforcing medication instructions and advises the client to:

• A. Take the medication with food.
• B. Increase fluid intake to 2000 to 3000 mL daily.
• C. Decrease sodium intake while taking the medication.
• D. Increase potassium intake while taking the medication.

Correct answer: B

Rationale: The correct answer is to increase fluid intake to 2000 to 3000 mL daily. Cyclophosphamide can cause hemorrhagic cystitis as a toxic effect. By increasing fluid intake, the client can help prevent this complication by promoting frequent urination, which reduces the concentration of the drug and its metabolites in the bladder. This dilution effect can help reduce the risk of bladder toxicity.

2. Which laboratory test should the nurse monitor to determine the effectiveness of heparin therapy for a client with deep vein thrombosis?

• A. Platelet count
• B. Prothrombin time (PT)
• C. Activated partial thromboplastin time (aPTT)
• D. Hemoglobin and hematocrit

Correct answer: C

Rationale: The activated partial thromboplastin time (aPTT) is the specific laboratory test used to monitor the effectiveness of heparin therapy in patients with deep vein thrombosis. It measures the time it takes for blood to clot and is crucial in assessing the therapeutic range of heparin. Platelet count, prothrombin time (PT), and hemoglobin and hematocrit levels are important parameters in assessing coagulation and blood status but do not directly indicate the effectiveness of heparin therapy.

3. The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:

• A. Acne
• B. Eczema
• C. Hair loss
• D. Herpes simplex

Correct answer: A

Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.

4. A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache?

• A. Naproxen (Aleve)
• B. Ibuprofen (Advil)
• C. Acetaminophen (Tylenol)
• D. Acetylsalicylic acid (aspirin)

Correct answer: C

Rationale: Acetaminophen is the preferred choice for pain relief in individuals taking lansoprazole for Zollinger-Ellison syndrome due to its lower risk of stomach irritation compared to NSAIDs like ibuprofen and aspirin. Naproxen, ibuprofen, and aspirin are NSAIDs that can increase the risk of stomach irritation and bleeding, which is why they are not recommended for individuals with Zollinger-Ellison syndrome who are already on lansoprazole to reduce stomach acid production.

5. A client is prescribed phenytoin (Dilantin) for seizure control. Which statement by the client indicates an understanding of the medication?

• A. I should brush and floss my teeth regularly.
• B. I should take the medication with antacids.
• C. I can stop taking the medication once my seizures are controlled.
• D. I should avoid drinking milk while taking this medication.

Correct answer: A

Rationale: The correct statement is 'I should brush and floss my teeth regularly.' Phenytoin (Dilantin) can cause gingival hyperplasia, so maintaining good oral hygiene is essential. Taking the medication with antacids can affect its absorption, so it should not be done. It is crucial not to stop taking the medication abruptly, even if seizures are controlled. There is no specific requirement to avoid milk while taking phenytoin (Dilantin).

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