Nursing Elites

1. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. To ensure optimal absorption, the client should alternate nostrils daily when inhaling the medication. This practice helps prevent irritation and promotes consistent drug delivery through both nostrils. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed as a tablet, applied topically, or mixed with juice; it is usually administered intranasally.

2. When starting therapy with bicalutamide, a client should be instructed to monitor for which of the following adverse effects?

• A. Muscle pain
• B. Flushing
• C. Gynecomastia
• D. Hyperglycemia

Correct answer: C

Rationale: The correct answer is C: Gynecomastia. Bicalutamide, due to its antiandrogenic properties, can lead to gynecomastia in clients. This condition involves the development of breast tissue in males and is an important adverse effect to monitor when taking this medication. Choices A, B, and D are incorrect. Muscle pain and flushing are not commonly associated with bicalutamide use. Hyperglycemia is not a typical adverse effect of bicalutamide therapy.

3. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

4. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

5. When a client is taking Somatropin to stimulate growth, what should the healthcare provider monitor the client's urine for?

• A. Bilirubin
• B. Protein
• C. Potassium
• D. Calcium

Correct answer: D

Rationale: When a client is taking Somatropin to stimulate growth, monitoring urine for calcium is essential. Somatropin can lead to increased calcium levels in the urine, potentially increasing the risk of renal calculi formation. Therefore, assessing for calcium in the urine helps in early detection and prevention of this complication. Monitoring for bilirubin, protein, or potassium in the urine is not directly related to the effects of Somatropin and would not provide relevant information in this context.

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