Nursing Elites

1. A client is starting therapy with doxorubicin. Which of the following findings should the nurse instruct the client to report?

• A. Hair loss
• B. Fatigue
• C. Sore throat
• D. Red urine

Correct answer: C

Rationale: The correct answer is 'C: Sore throat.' Doxorubicin is known to have immunosuppressive effects, which can predispose the client to infections. A sore throat can be an early sign of infection, and prompt reporting to the healthcare provider is crucial to initiate appropriate interventions and prevent complications. Choices A, B, and D are incorrect because hair loss, fatigue, and red urine are common side effects of doxorubicin and are typically expected during therapy. While these side effects should be monitored, they do not require immediate reporting unless they become severe or concerning.

2. A healthcare professional is preparing to administer vancomycin to a client. The professional should monitor for which of the following adverse effects?

• A. Nephrotoxicity
• B. Hepatotoxicity
• C. Red Man Syndrome
• D. Diarrhea

Correct answer: C

Rationale: Red Man Syndrome is a common adverse effect of vancomycin characterized by flushing and rash. It is not related to nephrotoxicity, hepatotoxicity, or diarrhea. Monitoring for this reaction allows for prompt intervention to prevent severe complications.

3. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.

4. A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?

• A. Sodium 140 mEq/L
• B. Potassium 4.5 mEq/L
• C. BUN 55 mg/dL
• D. Glucose 120 mg/dL

Correct answer: C

Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.

5. A client is prescribed Diltiazem. Which of the following findings should the nurse monitor?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Hyperkalemia

Correct answer: B

Rationale: Diltiazem is a calcium channel blocker that can lead to bradycardia as an adverse effect due to its negative chronotropic and dromotropic effects on the heart. The nurse should monitor the client's heart rate regularly to detect any signs of bradycardia and take appropriate actions if necessary. Tachycardia (Choice A) is not an expected finding with Diltiazem use. Hypertension (Choice C) is actually a condition that Diltiazem is used to treat. Hyperkalemia (Choice D) is not a common adverse effect of Diltiazem.

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