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 client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?

• A. Reflex tachycardia
• B. Dizziness
• C. Hyponatremia
• D. Hypotension

Correct answer: C

Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.

3. What symptom would alert the healthcare professional to hold Albuterol and notify a healthcare professional immediately?

• A. Insomnia
• B. Paradoxical bronchospasm
• C. Nausea
• D. Headache

Correct answer: B

Rationale: If a patient experiences paradoxical bronchospasm after taking Albuterol, the medication should be withheld, and a healthcare professional should be notified immediately. Paradoxical bronchospasm is a serious adverse reaction where the airways constrict instead of dilating, leading to breathing difficulties. This condition requires prompt medical attention to assess and manage the patient's respiratory status. The other options, insomnia, nausea, and headache, are not typically associated with the need to hold Albuterol and notify a healthcare professional immediately.

4. A nurse is teaching a client who has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will need to get my blood drawn periodically while on this medication.'
• B. I should stop taking this medication if I develop a rash.'
• C. I will need to limit my alcohol intake to no more than one drink per week.'
• D. I should self-administer this medication subcutaneously into the muscle.'

Correct answer: A

Rationale: Etanercept can cause bone marrow suppression, so it is important to monitor blood counts regularly.

5. A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Rise slowly from a sitting position.
• C. Avoid salt substitutes.
• D. Avoid exposure to sunlight.

Correct answer: C

Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.

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