Nursing Elites

1. A client has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the nurse perform first?

• A. Urine output
• B. Bowel sounds
• C. Pain level
• D. Respiratory rate

Correct answer: D

Rationale: The nurse should prioritize assessing the client's respiratory rate first when administering Morphine due to the risk of respiratory depression, which is a life-threatening adverse effect of this medication. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress early and take prompt action to ensure the client's safety. Assessing urine output, bowel sounds, and pain level are also important but not as critical as monitoring respiratory rate when initiating Morphine therapy.

2. A healthcare professional is educating a client who is beginning therapy with gemcitabine. Which of the following findings should the healthcare professional instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is dyspnea. Dyspnea can indicate pulmonary toxicity, a severe adverse effect associated with gemcitabine therapy. Prompt reporting of dyspnea allows for timely evaluation and management to prevent potential complications. Constipation, tinnitus, and dry mouth are not typically associated with gemcitabine therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings that the client should report.

3. A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?

• A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
• B. Leucovorin increases platelet production and prevents bleeding.
• C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
• D. Leucovorin protects healthy cells from Methotrexate's toxic effects.

Correct answer: D

Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment. Choices A, B, and C are incorrect because Leucovorin does not reduce the risk of a transfusion reaction from Methotrexate, increase platelet production, prevent bleeding, or potentiate the cytotoxic effects of Methotrexate. Instead, Leucovorin works by rescuing healthy cells from the toxic effects of Methotrexate.

4. A client is starting therapy with cisplatin. The healthcare provider should instruct the client to report which of the following adverse effects?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is tinnitus. Cisplatin can cause ototoxicity, which may manifest as tinnitus. Tinnitus should be reported promptly to the healthcare provider to prevent further hearing damage.

5. A client has a new prescription for Furosemide. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction to include when a client is prescribed Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these adverse effects and ensures the client's safety. Option A is incorrect because Furosemide is usually taken in the morning to prevent disturbed sleep due to frequent urination. Option B is incorrect as Furosemide can cause potassium loss, so advising to avoid foods high in potassium would not be appropriate. Option D is incorrect because taking Furosemide with meals may increase the risk of side effects and decrease its effectiveness.

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