Nursing Elites

1. What is the expected pharmacological action of propranolol?

• A. Block stimulation of beta1 receptors
• B. Alter water and electrolyte transport in the large intestine
• C. Block stimulation of beta2 receptors
• D. Both A and C are correct

Correct answer: D

Rationale: Propranolol exerts its pharmacological action by blocking stimulation of both beta1 and beta2 receptors. By doing so, it leads to decreased heart rate and blood pressure. Therefore, both options A and C are correct as propranolol affects both types of beta receptors. Choice B is incorrect as propranolol does not alter water and electrolyte transport in the large intestine.

2. 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 intravenously to prevent injury.
• B. Ensure that the medication is kept refrigerated until just prior to administration.
• C. Do not shake the vial; gently invert it to mix before withdrawing the dose.
• D. Discard the vial after removing one dose of the medication.

Correct answer: D

Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing. It is crucial not to shake the vial but gently invert it to mix the medication before withdrawing the appropriate dose. Refrigeration is not required for Filgrastim; it should be stored at room temperature until just before administration. Choice A is incorrect because Filgrastim is typically administered subcutaneously, not intravenously. Choice B is incorrect as the medication should be stored at room temperature, not refrigerated, until administration. Choice C is incorrect as shaking the vial is not recommended for Filgrastim.

3. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

• A. Increased renal secretion
• B. Increased medication-metabolizing enzymes
• C. Liver failure
• D. Peripheral vascular disease

Correct answer: C

Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.

4. Which of the following conditions is not treated with Dexamethasone?

• A. Inflammation
• B. Asthma
• C. Addison’s disease
• D. Wilson’s disease

Correct answer: D

Rationale: Dexamethasone is not used to treat Wilson’s disease. It is a corticosteroid primarily used for conditions like inflammation, asthma, and Addison’s disease. Wilson’s disease is a genetic disorder involving copper accumulation and is treated with medications like chelating agents or zinc salts, not Dexamethasone.

5. When assessing a client with chronic Neutropenia receiving Filgrastim, what action should the nurse take to evaluate for an adverse effect of the medication?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: The correct action when assessing a client receiving Filgrastim for chronic Neutropenia is to assess for bone pain. Bone pain is a known dose-related adverse effect of Filgrastim. Acetaminophen or opioid analgesics can be used to manage bone pain if necessary. Assessing for other types of pain, lung crackles, or heart murmurs would not be specific to the adverse effects of Filgrastim.

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