a nurse is teaching a client who is starting therapy with topotecan which of the following findings should the nurse instruct the client to report

ATI RN

ATI Pharmacology Proctored Exam 2023

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. Which of the following is the antidote for Heparin toxicity?

A. Protamine
B. Methylene blue
C. N-acetylcysteine
D. Glucagon

Correct answer: A

Rationale: Protamine is the specific antidote for Heparin toxicity. Heparin is an anticoagulant medication, and if an overdose occurs or if there is excessive bleeding due to Heparin use, protamine, a positively charged molecule, can neutralize the anticoagulant effects of Heparin by forming a complex with it. This binding prevents Heparin from further inhibiting coagulation factors and helps in reversing its effects.

3. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?

A. Bony orbit
B. Nasolacrimal duct
C. Conjunctival sac
D. Outer canthus

Correct answer: B

Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.

4. What is the antidote for copper toxicity?

A. Glucagon
B. Aminocaproic acid
C. Atropine
D. Penicillamine

Correct answer: D

Rationale: Penicillamine is the specific chelating agent used for copper toxicity. It forms stable complexes with copper, which are then excreted in the urine. Glucagon is used for treating hypoglycemia, aminocaproic acid is used to treat bleeding disorders, and atropine is used as an antidote for certain types of poisoning, such as organophosphate toxicity.

5. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

A. Furosemide
B. Captopril
C. Ranolazine
D. Metoprolol

Correct answer: D

Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients who develop tachycardia, such as in the case of reflex tachycardia induced by Isosorbide Mononitrate, making it the appropriate choice in this scenario. Furosemide (Choice A) is a loop diuretic used for conditions like heart failure and edema, not for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor primarily used for hypertension and heart failure, not for reflex tachycardia. Ranolazine (Choice C) is used for chronic angina but does not specifically address reflex tachycardia.