Nursing Elites

1. 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 subcutaneously in a large muscle mass to prevent injury.
• B. Ensure that the medication is kept at room temperature until just prior to administration.
• C. Invert vial gently to mix well before withdrawing dose.
• D. Discard vial after removing one dose of the medication.

Correct answer: D

Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.

2. A patient is receiving IV heparin for a deep-vein thrombosis and begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

• A. Vitamin K1
• B. Atropine
• C. Protamine
• D. Calcium gluconate

Correct answer: C

Rationale: Protamine is the antidote for heparin, as it reverses its anticoagulant effects. In cases of heparin overdose or if there is excessive bleeding, administering protamine can quickly neutralize the effects of heparin, helping to prevent further bleeding complications.

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

• A. Take this medication at bedtime.
• B. Take this medication with food.
• C. Take this medication on an empty stomach in the morning.
• D. Take this medication with an antacid.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance its absorption. This timing allows for optimal absorption and effectiveness of the medication. Taking it with food, at bedtime, or with an antacid may interfere with its absorption and reduce its efficacy.

4. A client has a new prescription for Furosemide. Which of the following adverse effects should the nurse monitor?

• A. Hyperkalemia
• B. Hyponatremia
• C. Hypernatremia
• D. Hypercalcemia

Correct answer: B

Rationale: Furosemide is a diuretic that commonly causes hyponatremia (low sodium levels) due to its effect on sodium and water excretion. The nurse must closely monitor the client for signs of hyponatremia, such as weakness, confusion, and muscle cramps, and promptly intervene to prevent complications. Choices A, C, and D are incorrect because Furosemide is not associated with hyperkalemia, hypernatremia, or hypercalcemia. Understanding the medication's mechanism of action helps prioritize monitoring for potential adverse effects.

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

• A. Take this medication before bed.
• B. Take the medication with food.
• C. Sit upright for at least 30 minutes after taking the medication.
• D. Expect to have frequent headaches while on this medication.

Correct answer: C

Rationale: The correct instruction for a client prescribed Alendronate is to sit upright for at least 30 minutes after taking the medication. Alendronate can cause esophageal irritation, and maintaining an upright position helps prevent this adverse effect by reducing the risk of reflux of the medication into the esophagus. Choice A is incorrect because Alendronate should be taken in the morning, at least 30 minutes before the first food, beverage, or medication of the day with a full glass of plain water. Choice B is incorrect because Alendronate should not be taken with food. Choice D is incorrect because frequent headaches are not a common side effect of Alendronate.

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