Nursing Elites

1. When starting therapy with cisplatin, a client should report which of the following adverse effects as instructed by the nurse?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The nurse should instruct the client to report tinnitus because it can be an indication of ototoxicity, a potential adverse effect of cisplatin. Ototoxicity can manifest as tinnitus, hearing loss, or balance disturbances, so it is crucial for the client to promptly report any changes in hearing such as tinnitus to prevent further damage.

2. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function and potential worsening heart failure. This finding should be reported promptly to the provider for further evaluation and management to prevent complications. Weight loss, while significant, may be expected with diuretic use. A blood pressure of 104/60 mm Hg is within normal range and can be managed. A potassium level of 3.5 mEq/L is slightly low but not an immediate concern.

3. What is one therapeutic use for nitroglycerin?

• A. Relief or prevention of anginal attacks
• B. Diuresis and mobilization of excess fluid
• C. Decreasing nausea and vomiting
• D. Relief of anxiety

Correct answer: A

Rationale: Nitroglycerin is primarily used for the relief or prevention of anginal attacks. It works by dilating blood vessels, increasing blood flow and oxygen to the heart muscle, thereby relieving chest pain caused by angina. The medication is not indicated for diuresis, antiemetic effects, or anxiety relief. Therefore, choices B, C, and D are incorrect as they do not reflect the therapeutic use of nitroglycerin.

4. 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.

5. When administering subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty, what action should the nurse plan to take?

• A. Expel any air bubbles from the prefilled syringe before injecting.
• B. Insert the needle completely into the client's tissue.
• C. Administer the injection in the client's thigh.
• D. Aspirate carefully after inserting the needle into the client's skin.

Correct answer: B

Rationale: When administering enoxaparin via a prefilled syringe for deep subcutaneous injection, the nurse should insert the needle completely into the client's tissue. This action ensures proper delivery of the medication into the subcutaneous layer, promoting optimal therapeutic effects. Choice A is incorrect because there is no need to expel air bubbles from a prefilled syringe. Choice C is incorrect as enoxaparin is typically administered in the abdomen for subcutaneous injections. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or damage to tissues.

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