Nursing Elites

1. A client is starting therapy with topotecan. 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 nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of topotecan. Monitoring for signs of infection is crucial to prevent complications during therapy. Choices A, B, and D are less critical findings compared to a sore throat. Hair loss is a common side effect of chemotherapy, fatigue is expected with cancer treatment, and red urine is a known harmless effect of topotecan.

2. A client with increased liver enzymes is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

• A. Glucosamine
• B. Saw palmetto
• C. Kava
• D. St. John's wort

Correct answer: C

Rationale: Chronic use or high doses of kava have been associated with liver damage, including severe liver failure. Therefore, the nurse should report the client's use of kava to the healthcare provider for further evaluation and management.

3. When a client is prescribed hydrochlorothiazide, what adverse effect should they monitor for as instructed by the nurse?

• A. Hyponatremia
• B. Ototoxicity
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: A

Rationale: Hyponatremia is a critical adverse effect associated with hydrochlorothiazide use. This medication is a diuretic that can lead to excessive loss of sodium and water from the body, potentially causing low sodium levels and resulting in hyponatremia. Monitoring for signs and symptoms of hyponatremia, such as confusion, headache, weakness, and muscle cramps, is essential to prevent serious complications. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) and hyperkalemia (choice D) are also not typically associated with hydrochlorothiazide use.

4. A healthcare professional is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the healthcare professional?

• A. Perform immediate gastric lavage.
• B. Prepare the client for hemodialysis.
• C. Administer an additional oral dose of lithium.
• D. Request a stat repeat of the laboratory test.

Correct answer: A

Rationale: Performing immediate gastric lavage is the appropriate action for a client with severe lithium toxicity, indicated by a plasma lithium level of 2.1 mEq/L. Gastric lavage can help reduce the client's lithium level by removing the unabsorbed drug from the stomach.

5. A healthcare professional is preparing a client's medications. Which of the following actions should the professional take to follow legal practice guidelines? (Select all that apply.)

• A. Maintain skill competency.
• B. Determine the dosage.
• C. Monitor for adverse effects.
• D. Safeguard medications.

Correct answer: A

Rationale: Maintaining skill competency is a critical aspect of legal practice guidelines for healthcare professionals. It is essential to ensure that healthcare professionals are competent and up-to-date with their skills to provide safe and effective care to patients. While determining the dosage, monitoring for adverse effects, and safeguarding medications are important aspects of medication administration, maintaining skill competency is a fundamental legal responsibility that ensures the delivery of quality care. Determining the dosage and monitoring for adverse effects are clinical responsibilities, while safeguarding medications pertains to proper storage and handling, not specifically related to legal practice guidelines.

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