Nursing Elites

1. A client is receiving treatment with vincristine. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Neurotoxicity
• C. Neutropenia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for neurotoxicity is crucial to detect any signs early. Choices A, C, and D are incorrect. Hyperkalemia is not a typical finding associated with vincristine. Neutropenia is a common side effect of chemotherapy but is not directly related to vincristine. Bradycardia is not a common adverse effect of vincristine.

2. A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?

• A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
• B. Avoid blinking immediately after instilling the drops.
• C. Keep your eyes closed for 5 minutes after application.
• D. Administer the drops directly onto the cornea.

Correct answer: A

Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.

3. While caring for a client on long-term aspirin therapy, the nurse should monitor the client for which of the following complications?

• A. Hemorrhagic stroke
• B. Thromboembolic stroke
• C. Iron deficiency anemia
• D. Neutropenia

Correct answer: A

Rationale: Corrected Rationale: Long-term aspirin therapy can increase the risk of hemorrhagic stroke due to its antiplatelet effects, which can lead to bleeding complications. Aspirin inhibits platelet function, potentially causing bleeding in the brain and increasing the risk of a hemorrhagic stroke. Choice B, thromboembolic stroke, is incorrect because aspirin therapy is actually used to prevent thromboembolic events by inhibiting platelet aggregation. Choices C and D, iron deficiency anemia and neutropenia, are not directly associated with long-term aspirin therapy.

4. A client in a substance abuse clinic is being assessed by a nurse after discontinuing disulfiram due to severe nausea and vomiting. What is the likely cause of the client's distress?

• A. The client demonstrated an allergic response to the medication.
• B. The client experienced a common side effect of the medication.
• C. The client consumed alcohol while taking the medication.
• D. The client took an overdose of the medication.

Correct answer: C

Rationale: Disulfiram, when combined with alcohol, leads to a severe reaction causing nausea and vomiting. Since the client experienced these symptoms after starting disulfiram, it is likely that they consumed alcohol while taking the medication. Choice A is incorrect because the symptoms are more indicative of the interaction with alcohol rather than an allergic response. Choice B is incorrect as severe nausea and vomiting are not common side effects of disulfiram alone. Choice D is incorrect as there is no indication of an overdose based on the symptoms described.

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

• A. You will need to have your blood tested regularly while taking this medication.
• B. It is safe to take over-the-counter NSAIDs with this medication.
• C. You will need to avoid foods high in vitamin K while taking this medication.
• D. You will need to take this medication with food.

Correct answer: C

Rationale: Warfarin interacts with vitamin K, so clients should be instructed to avoid foods high in vitamin K. This is because vitamin K can interfere with the anticoagulant effects of Warfarin. It is important to maintain a consistent intake of vitamin K-containing foods to keep the medication working effectively. Therefore, the correct statement for the nurse to include in the teaching is to advise the client to avoid foods high in vitamin K while taking Warfarin. Choices A, B, and D are incorrect. Regular blood testing is necessary with Warfarin to monitor its effects and adjust the dosage if needed (Choice A). Taking over-the-counter NSAIDs with Warfarin is not safe due to an increased risk of bleeding (Choice B). Warfarin can be taken with or without food, so there is no specific requirement to take it with food (Choice D).

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