Nursing Elites

1. A client with breast cancer is being taught by a nurse about the adverse effects of chemotherapy. Which of the following statements should the nurse include?

• A. You should use a soft-bristled toothbrush to prevent bleeding.
• B. You should avoid contact with individuals who recently received live virus vaccines.
• C. You should take aspirin for minor aches and pains.
• D. You should consume a diet low in protein to reduce the risk of renal damage.

Correct answer: A

Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia. Chemotherapy can decrease platelet counts, leading to an increased risk of bleeding. Using a soft-bristled toothbrush can help prevent gum bleeding and oral trauma. Choices B, C, and D are incorrect. Avoiding contact with individuals who recently received live virus vaccines is crucial to prevent infections in immunocompromised clients. Aspirin should be avoided due to its blood-thinning effects that can increase the risk of bleeding. A diet low in protein is not recommended as cancer clients often require adequate protein intake for healing and recovery.

2. When using Nitroglycerine (transdermal), how many hours should you be nitrate-free each day?

• A. 1-2 hours
• B. 5-10 hours
• C. 3-4 hours
• D. 10-12 hours

Correct answer: D

Rationale: When using Nitroglycerine (transdermal), it should be applied for 10-12 hours per day to ensure its effectiveness. A nitrate-free period within the day is essential to prevent the development of tolerance to the medication.

3. When educating a client starting Simvastatin, which instruction should the nurse provide?

• A. Take this medication in the evening.
• B. Change positions slowly when rising from a chair.
• C. Maintain a consistent intake of green leafy vegetables.
• D. Limit fluid intake to 1 L per day.

Correct answer: A

Rationale: The correct answer is to take Simvastatin in the evening. This timing is important because the body synthesizes the most cholesterol at night. By taking the medication in the evening, its effectiveness is increased, leading to better outcomes for the client.

4. A client has a new prescription for Lisinopril. Which of the following laboratory values should be monitored?

• A. Serum potassium
• B. Serum sodium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: Corrected Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by reducing potassium excretion through the kidneys. Monitoring serum potassium levels is crucial to detect hyperkalemia early and prevent adverse effects such as cardiac arrhythmias. Choices B, C, and D are incorrect because Lisinopril is not known to significantly impact sodium, calcium, or magnesium levels in the same way it affects potassium levels.

5. Which of the following is the antidote for benzodiazepine toxicity?

• A. Flumazenil
• B. Methylene blue
• C. Deferoxamine
• D. Alkalinize urine

Correct answer: A

Rationale: Flumazenil is the specific antidote for benzodiazepine toxicity. It acts as a competitive antagonist at the benzodiazepine binding site on the GABA receptor, reversing the sedative effects of benzodiazepines. Administration of flumazenil is indicated in cases of benzodiazepine overdose or toxicity to rapidly reverse the central nervous system depression caused by these drugs. It is important to note that flumazenil should be used cautiously in patients with a history of seizures or those who are physically dependent on benzodiazepines, as it can precipitate withdrawal symptoms or seizures.

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