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 has a new prescription for Raltegravir. Which of the following statements should the nurse include in teaching the client?

• A. This medication prevents the virus from entering the cell.
• B. This medication prevents the virus from leaving the cell.
• C. This medication blocks the virus from attaching to the cell.
• D. This medication blocks the virus from replicating in the cell.

Correct answer: D

Rationale: The correct answer is D because Raltegravir works by blocking the integrase enzyme, preventing the virus from integrating its genetic material into the host cell's DNA. By inhibiting this process, viral replication within the host cell is halted. Choices A, B, and C are incorrect because Raltegravir's mechanism of action specifically targets viral replication within the cell, not virus entry, exit, or attachment to the cell.

3. Which of the following drugs is associated with the reaction of Cinchonism?

• A. Valproic acid
• B. Quinidine
• C. Isoniazid
• D. Ethosuximide

Correct answer: B

Rationale: Cinchonism is associated with Quinidine, not Valproic acid, Isoniazid, or Ethosuximide. Cinchonism is characterized by symptoms such as tinnitus, dizziness, and headaches. Quinidine, being an antiarrhythmic agent, can lead to this condition as a side effect.

4. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Remove the nitroglycerin patch for 30 minutes if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each evening to prevent tolerance. This allows for a nitrate-free period of 10 to 12 hours during each 24-hour period, reducing the risk of developing tolerance to the medication. Choice B is incorrect because cutting the patch could alter the dose delivery and is not recommended. Choice C is incorrect as removing the patch for 30 minutes when a headache occurs may not be effective in managing symptoms. Choice D is incorrect as Nitroglycerin patches are usually applied once daily, not every 48 hours.

5. What are the actions of the drug metformin?

• A. Decreases hepatic glucose production and intestinal glucose absorption
• B. Increases sensitivity to insulin
• C. Short-term sedation
• D. Both A and B

Correct answer: D

Rationale: Metformin has dual actions by decreasing hepatic glucose production and intestinal glucose absorption, which helps in reducing blood glucose levels. Additionally, it increases sensitivity to insulin, aiding in its proper utilization within the body. Choice A is correct as metformin acts by decreasing hepatic glucose production and intestinal glucose absorption. Choice B is also correct as metformin increases sensitivity to insulin. Choice C, short-term sedation, is incorrect as metformin is not known for causing sedation. Therefore, the correct answer is D because metformin performs both of these actions.

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