Nursing Elites

1. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots forming and leading to serious complications like pulmonary embolism. Clients with a history of deep-vein thrombosis are at a higher risk of recurrent thromboembolic events when taking tamoxifen, making it unsafe for such individuals. Choices B, C, and D are not contraindications for tamoxifen therapy, as migraine headaches, hypertension, and anemia do not directly interact with tamoxifen's mechanism of action or pose significant risks when used together.

2. When educating a patient on taking levothyroxine, a drug used to balance thyroid activity, what should you include in their education?

• A. Don't disregard side effects and consult your healthcare professionals
• B. Take this at the same time every day
• C. Thyroid tests are necessary while taking this drug
• D. It is not recommended to take this drug if you have recently had a myocardial infarction

Correct answer: B

Rationale: The correct answer is to take levothyroxine at the same time every day. Consistent timing helps maintain stable thyroid levels, ensuring the effectiveness of the medication. It is important to establish a routine to optimize its therapeutic benefits. Choice A is incorrect as patients should not ignore side effects but should consult healthcare professionals if they experience any. Choice C is incorrect because thyroid tests may still be necessary to monitor thyroid function while on levothyroxine. Choice D is incorrect as it is not advisable to take levothyroxine if the patient has recently had a myocardial infarction without consulting their healthcare provider.

3. A client with Subacute Bacterial Endocarditis is receiving Streptomycin IM among other antibiotics. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

• A. Extremity paresthesias
• B. Urinary retention
• C. Severe constipation
• D. Complex partial seizures

Correct answer: A

Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly. Choices B, C, and D are incorrect because urinary retention, severe constipation, and complex partial seizures are not commonly associated adverse effects of Streptomycin.

4. When assessing a client taking Gemfibrozil, which of the following findings should the nurse identify as an adverse reaction to the medication?

• A. Mental status changes
• B. Tremor
• C. Jaundice
• D. Pneumonia

Correct answer: C

Rationale: Jaundice is an adverse reaction that can occur in clients taking Gemfibrozil due to the potential development of liver impairment. Other symptoms of liver impairment may include anorexia and upper abdominal discomfort. Monitoring for signs of jaundice is crucial to detect and manage adverse effects of the medication promptly. Mental status changes (choice A) are not commonly associated with Gemfibrozil use. Tremor (choice B) is not a typical adverse reaction of Gemfibrozil. Pneumonia (choice D) is not directly linked to Gemfibrozil use but can be a complication in some cases.

5. A patient is receiving spironolactone for heart failure. Which of the following findings should the nurse report to the provider?

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

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient. Choices B, C, and D are incorrect because spironolactone is not associated with hypernatremia, hyponatremia, or hypokalemia. Hyperkalemia is the critical finding that the nurse should report in a patient receiving spironolactone.

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