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. A client has a new prescription for Verapamil to control hypertension. Which of the following instructions should the nurse include?

• A. Increase the amount of dietary fiber in the diet.
• B. Drink grapefruit juice daily to increase vitamin C intake.
• C. Decrease the amount of calcium in the diet.
• D. Withhold food for 1 hr after taking the medication.

Correct answer: A

Rationale: Increasing dietary fiber intake is essential when taking Verapamil to prevent constipation, a common adverse effect of this medication. Verapamil is a calcium channel blocker used to treat hypertension, and dietary fiber helps maintain bowel regularity and prevent constipation that may occur as a side effect of the medication.

3. A healthcare professional is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare professional plan to take?

• A. Administer IM Enoxaparin along with the Alteplase dose.
• B. Hold direct pressure on puncture sites for up to 30 min.
• C. Administer Aminocaproic acid IV prior to alteplase infusion.
• D. Prepare to administer Alteplase within 8 hr of manifestation onset.

Correct answer: B

Rationale: The correct intervention when administering IV Alteplase is to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This helps prevent bleeding complications associated with thrombolytic therapy. Administering IM Enoxaparin is not indicated with Alteplase, as it is an anticoagulant rather than a thrombolytic agent. Aminocaproic acid is not typically administered prior to alteplase infusion in the context of a massive Pulmonary Embolism. While timely administration of Alteplase is important, the specific timeframe within which it should be administered may vary based on the clinical situation, so a strict 8-hour window is not universally applicable.

4. 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.

5. What is a common side effect that typically occurs with the initial therapy of Nitroglycerine as a result of increased vasodilation?

• A. Abdominal cramps
• B. Calf pain
• C. Headache
• D. Blurred vision

Correct answer: C

Rationale: Headache is a common side effect associated with the initial therapy of Nitroglycerine due to its vasodilatory properties. The vasodilation caused by Nitroglycerine leads to relaxation of blood vessels, including those in the head, which can result in headaches. This side effect is considered normal and is often transient, diminishing with continued use of the medication.

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