Nursing Elites

1. A client with cancer is prescribed methotrexate. Which supplement should the healthcare provider recommend to reduce the risk of methotrexate toxicity?

• A. Folic acid
• B. Magnesium
• C. Vitamin D
• D. Iron

Correct answer: A

Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, and supplementing with folic acid can help reduce the risk of methotrexate toxicity. Folic acid supplementation is commonly recommended to counteract the effects of methotrexate on folate metabolism. Magnesium, Vitamin D, and Iron are not specifically indicated to reduce the risk of methotrexate toxicity and therefore are incorrect choices in this scenario.

2. A client is receiving spironolactone. Which of the following findings should the nurse report to the provider?

• A. Serum Sodium 144 mEq/L
• B. Urine output 120 mL in 4 hrs
• C. Serum Potassium 5.2 mEq/L
• D. Blood Pressure 140/90 mmHg

Correct answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to potassium retention. The nurse should notify the provider and withhold the medication to prevent further elevation of potassium levels, which can result in serious cardiac complications. The other findings (Serum Sodium 144 mEq/L, Urine output 120 mL in 4 hrs, and Blood Pressure 140/90 mmHg) are within normal ranges and not directly related to spironolactone therapy.

3. ACE Inhibitors are used in the treatment of all EXCEPT:

• A. Hypertension
• B. Heart Failure
• C. Hypotension
• D. Diabetic nephropathy

Correct answer: C

Rationale: ACE inhibitors are commonly used in the treatment of hypertension, heart failure, and diabetic nephropathy due to their ability to reduce blood pressure, improve heart function, and protect the kidneys. However, they are not indicated for hypotension as they can further lower blood pressure, worsening the condition. Therefore, the correct answer is C. Choice A, hypertension, is correct as ACE inhibitors are a first-line treatment for this condition. Choice B, heart failure, is also correct as ACE inhibitors help improve heart function in patients with heart failure. Choice D, diabetic nephropathy, is correct as ACE inhibitors can slow the progression of kidney damage in diabetic patients.

4. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

5. Which of the following is not directly related to the drug toxicity of Ibuprofen?

• A. Nausea
• B. Renal dysfunction
• C. Anemia
• D. Muscle wasting

Correct answer: D

Rationale: Ibuprofen is known to cause adverse effects such as nausea, renal dysfunction, and anemia. However, muscle wasting is not a common toxicity associated with Ibuprofen use. Therefore, the correct answer is D.

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