Nursing Elites

1. A client has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

• A. Colchicine
• B. Hydroxychloroquine
• C. Auranofin
• D. Duloxetine

Correct answer: D

Rationale: The correct answer is D, Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor commonly used to manage fibromyalgia. It helps in reducing pain and improving mood in individuals with this condition. Colchicine (Choice A) is primarily used to treat gout, while Hydroxychloroquine (Choice B) and Auranofin (Choice C) are medications used to manage conditions like rheumatoid arthritis and lupus, not fibromyalgia.

2. A client is prescribed Lithium. Which of the following laboratory values should be monitored to assess for potential toxicity?

• A. Serum sodium
• B. Serum lithium
• C. Serum potassium
• D. Serum calcium

Correct answer: B

Rationale: When a client is prescribed Lithium, monitoring serum lithium levels is crucial to ensure they remain within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels helps prevent adverse effects associated with lithium toxicity, such as nausea, vomiting, diarrhea, tremors, and confusion.

3. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

4. A client is starting therapy with filgrastim. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bone pain
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: When a client is starting therapy with filgrastim, monitoring for bone pain is essential. Filgrastim can lead to increased bone marrow activity, resulting in bone pain as a common adverse effect. Instructing the client to monitor and report any bone pain promptly can help in managing this side effect effectively.

5. A client has a new prescription for Nevirapine, an NNRTI. Which of the following statements should the nurse include in teaching the client?

• A. Take this medication on an empty stomach.
• B. Take this medication with food to increase absorption.
• C. Avoid alcohol while taking this medication.
• D. Take this medication at the same time every day.

Correct answer: B

Rationale: The correct statement that the nurse should include in teaching the client about Nevirapine, an NNRTI, is to take the medication with food to improve gastrointestinal tolerance and prevent nausea. While absorption is not significantly affected by food, taking it with meals can help reduce adverse gastrointestinal effects. Choice A is incorrect because Nevirapine should not be taken on an empty stomach. Choice C is generally true for most medications but is not specific to Nevirapine. Choice D is a good practice for medication adherence but is not specific to the administration requirements of Nevirapine.

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