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 been prescribed Alendronate for osteoporosis. Which of the following instructions should the nurse provide?

• A. Take the medication with a full glass of water after getting up in the morning.
• B. Remain upright for at least 30 minutes after taking the medication.
• C. Chew the tablet and mix it with applesauce if swallowing is difficult.
• D. Take the medication at bedtime to minimize the chance of esophageal irritation.

Correct answer: A

Rationale: The correct instruction for a client prescribed Alendronate for osteoporosis is to take the medication with a full glass of water after getting up in the morning. This is important to reduce the risk of esophageal irritation. Choice B is also correct as remaining upright for at least 30 minutes after taking the medication helps prevent esophageal irritation and ensures proper absorption. Choice C is incorrect because Alendronate tablets should not be chewed or mixed with any other substance. Choice D is incorrect as taking the medication at bedtime increases the risk of esophageal irritation due to lying down after ingestion.

3. A client is receiving discharge instructions for a new prescription of Prednisone. Which of the following dietary instructions should be included?

• A. Increase your intake of potassium-rich foods.
• B. Increase your intake of dairy products.
• C. Avoid foods high in vitamin K.
• D. Decrease your intake of protein.

Correct answer: A

Rationale: When a client is prescribed Prednisone, there is a risk of potassium depletion due to the medication. Therefore, it is essential to increase the intake of potassium-rich foods such as bananas, oranges, and spinach to help maintain adequate potassium levels in the body and prevent complications associated with low potassium levels. Choice B and D are incorrect as there is no specific need to increase dairy products or decrease protein intake with Prednisone. Choice C is also incorrect as avoiding foods high in vitamin K is more relevant for clients taking anticoagulants like warfarin.

4. Which medication is contraindicated with Nitroglycerin?

• A. Hydrochloroquine
• B. Methylprednisolone
• C. Phenazopyridine
• D. Erectile dysfunction drugs

Correct answer: D

Rationale: The correct answer is D: Erectile dysfunction drugs. Erectile dysfunction drugs are contraindicated with Nitroglycerin because they can potentiate the hypotensive effects of Nitroglycerin, leading to severe hypotension. Choices A, B, and C are incorrect because they are not known to have significant interactions with Nitroglycerin.

5. While providing teaching to a client with a new prescription for Enalapril, the nurse should instruct the client to report which of the following manifestations as an adverse effect of this medication?

• A. Tremors
• B. Dry cough
• C. Drowsiness
• D. Hyperactivity

Correct answer: B

Rationale: The correct answer is 'B: Dry cough.' Enalapril is an ACE inhibitor known to cause a persistent dry cough as a common adverse effect. This cough should be reported to the healthcare provider for further evaluation, as it may indicate a potential issue with the medication that needs attention to ensure the client's well-being. Tremors (Choice A), drowsiness (Choice C), and hyperactivity (Choice D) are not typically associated with Enalapril use. Therefore, they are incorrect choices for this question.

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