Nursing Elites

1. When providing teaching to a client starting therapy with trastuzumab, which finding should the nurse instruct the client to report?

• A. Dyspnea
• B. Constipation
• C. Tinnitus
• D. Dry mouth

Correct answer: A

Rationale: The correct answer is A: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a serious adverse effect of trastuzumab. Monitoring and early reporting of respiratory symptoms like dyspnea are essential to prevent further complications and ensure timely intervention. Choices B, C, and D are incorrect because constipation, tinnitus, and dry mouth are not typically associated with trastuzumab therapy and are not priority symptoms that require immediate reporting for this specific medication.

2. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: The correct answer is B: Fever. Fever is a key symptom of serotonin syndrome, a potentially life-threatening condition that can occur with the use of serotonergic medications like Sertraline. Serotonin syndrome is characterized by a combination of symptoms, including fever, agitation, rapid heartbeat, sweating, shivering, tremors, and in severe cases, it can lead to seizures, coma, and even death. Bruising (Choice A), abdominal pain (Choice C), and rash (Choice D) are not typically associated with serotonin syndrome. Therefore, the nurse should be vigilant in monitoring for fever as an early sign of serotonin syndrome in clients taking Sertraline.

3. A client has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

• A. Bruising
• B. Fever
• C. Abdominal pain
• D. Rash

Correct answer: B

Rationale: Fever is a key symptom of serotonin syndrome, a potentially serious condition that can occur with the use of SSRIs like Sertraline. Serotonin syndrome is characterized by excessive levels of serotonin in the body, leading to symptoms such as fever, agitation, confusion, tremors, and sweating. If a client on Sertraline presents with fever, the nurse should consider the possibility of serotonin syndrome and take appropriate actions such as notifying the healthcare provider and monitoring the client closely. Bruising, abdominal pain, and rash are not typically associated with serotonin syndrome and are more likely to be indicative of other conditions or side effects.

4. To which pharmacologic classification does the drug propranolol belong?

• A. Beta Blockers
• B. Cholinergics
• C. Immune globulins
• D. Barbiturates

Correct answer: A

Rationale: Propranolol belongs to the pharmacologic classification of Beta Blockers. Beta blockers work by blocking the action of adrenaline and other stress hormones on beta-adrenergic receptors. They are commonly used to manage conditions like high blood pressure, angina, and arrhythmias. Choice B, Cholinergics, is incorrect because cholinergics work by stimulating the parasympathetic nervous system, unlike beta blockers that block adrenergic receptors. Choice C, Immune globulins, is incorrect as it refers to antibodies used to boost the immune system, not the mechanism of action of propranolol. Choice D, Barbiturates, is incorrect as barbiturates are a different class of drugs that act as central nervous system depressants, primarily used as sedatives and anesthetics.

5. A client with end-stage cancer receiving Morphine has been prescribed Methylnaltrexone. The client's daughter asks about the purpose of Methylnaltrexone. Which response should the nurse provide?

• A. The medication will increase your mother's respirations.
• B. The medication will prevent dependence on the Morphine.
• C. The medication will relieve your mother's constipation.
• D. The medication works with the Morphine to increase pain relief.

Correct answer: C

Rationale: Methylnaltrexone is an opioid antagonist used to treat severe constipation unresponsive to laxatives in opioid-dependent clients. It functions by blocking the mu opioid receptors in the gastrointestinal tract, helping alleviate constipation associated with opioid use. Choices A, B, and D are incorrect. Methylnaltrexone does not increase respirations, prevent dependence on Morphine, or work with Morphine to increase pain relief; its primary purpose is to relieve opioid-induced constipation.

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