Nursing Elites

1. A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?

• A. Apply warm compresses to the mouth
• B. Rinse mouth with alcohol-free mouthwash
• C. Increase fluid intake
• D. Clean the mouth gently with a soft toothbrush after meals

Correct answer: A

Rationale: The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.

2. A client receiving epoetin alfa therapy for anemia is being monitored for therapeutic effects. Which of the following laboratory values indicates the medication is effective?

• A. White blood cell count
• B. Hematocrit
• C. Platelet count
• D. Red blood cell count

Correct answer: B

Rationale: The correct answer is B: Hematocrit. An increase in hematocrit levels indicates the effectiveness of epoetin alfa in treating anemia. Hematocrit reflects the percentage of red blood cells in the blood, so an increase in hematocrit signifies an improvement in the patient's red blood cell count and oxygen-carrying capacity. Choices A, C, and D are incorrect because white blood cell count, platelet count, and red blood cell count do not directly reflect the therapeutic effects of epoetin alfa in treating anemia.

3. A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in the client education related to this medication?

• A. This medication is prescribed for long-term therapy prophylaxis against anginal attacks
• B. Do not crush this medication
• C. Take the medication in the evening after dinner
• D. Do not take an additional tablet if you experience chest pain

Correct answer: A

Rationale: The correct answer is A because isosorbide mononitrate is used for long-term prophylaxis against anginal attacks. Choice B is incorrect because isosorbide mononitrate should not be crushed. Choice C does not specify a particular time for medication administration. Choice D is incorrect because isosorbide mononitrate is not meant to be taken as needed for chest pain; it is part of a long-term therapy plan.

4. A nurse is reviewing the medical record of a client who is prescribed acetaminophen for pain. Which of the following lab values should the nurse monitor to identify an adverse effect of the medication?

• A. Serum glucose
• B. Serum creatinine
• C. Serum potassium
• D. Serum bilirubin

Correct answer: B

Rationale: The correct answer is B: Serum creatinine. Acetaminophen is metabolized by the liver, so serum creatinine levels should be monitored for potential hepatotoxicity. Monitoring serum creatinine can help detect liver damage, a potential adverse effect of acetaminophen. Choices A, C, and D are incorrect because serum glucose is not directly affected by acetaminophen, serum potassium is not typically monitored for acetaminophen adverse effects, and serum bilirubin is more related to bile metabolism rather than acetaminophen-induced hepatotoxicity.

5. A nurse is caring for a client prescribed clopidogrel. Which of the following client histories is a contraindication to the administration of this medication?

• A. Recent surgery
• B. Peptic ulcer disease
• C. Bleeding disorder
• D. Uncontrolled hypertension

Correct answer: D

Rationale: The correct answer is D: Uncontrolled hypertension. Clopidogrel should not be administered to clients with uncontrolled hypertension due to the increased risk of bleeding. Recent surgery, peptic ulcer disease, and bleeding disorders are not absolute contraindications for clopidogrel administration.

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