Nursing Elites

1. When caring for a client receiving treatment with irinotecan, which of the following findings should the nurse monitor?

• A. Diarrhea
• B. Hypertension
• C. Ototoxicity
• D. Neutropenia

Correct answer: A

Rationale: The correct answer is diarrhea. Irinotecan commonly causes diarrhea as an adverse effect due to its impact on the gastrointestinal tract. Monitoring for diarrhea is essential to prevent dehydration and manage this side effect effectively. Choices B, C, and D are incorrect as hypertension, ototoxicity, and neutropenia are not commonly associated with irinotecan therapy.

2. A client is starting therapy with topotecan. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

3. 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.

4. A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?

• A. Take this medication with your first bite of food.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication every other day.

Correct answer: A

Rationale: The correct answer is A: 'Take this medication with your first bite of food.' Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. By taking the medication with the first bite of food, the client can help minimize potential stomach upset and improve the drug's effectiveness. Choice B is incorrect because taking Metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect as there is no specific recommendation to take Metformin before bedtime. Choice D is incorrect because Metformin is typically taken daily, not every other day, as prescribed by the healthcare provider.

5. What instruction should the healthcare provider include to minimize an adverse effect of Clomipramine for OCD in an adolescent client?

• A. Wear sunglasses when outdoors.
• B. Check your temperature daily.
• C. Take this medication in the morning.
• D. Add extra calories to your diet.

Correct answer: A

Rationale: The correct answer is A: 'Wear sunglasses when outdoors.' To minimize the anticholinergic effect of Clomipramine, the client should wear sunglasses when outdoors to reduce photophobia. This adverse effect is common with tricyclic antidepressant (TCA) use. Choices B, C, and D are incorrect. Checking temperature daily, timing of medication intake, or adding extra calories to the diet are not directly related to minimizing adverse effects of Clomipramine.

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