Nursing Elites

1. A client with long-standing obesity has been prescribed phentermine/topiramate-ER. What statement by the client suggests that further health education is necessary?

• A. I'm so relieved to start this medication. I really don't like having to exercise or change what I eat.
• B. It's hard to believe that there are actually medications that can treat obesity.
• C. I'm a bit nervous to start this medication because I know I'll need blood tests sometimes.
• D. I'm going to have to do some rearranging of my finances to make sure I can afford this medication.

Correct answer: A

Rationale: Choice A suggests the need for further health education as the client expresses a reluctance to exercise or change dietary habits, indicating a lack of understanding about the importance of lifestyle modifications in conjunction with medication for effective weight management. It is important for the client to comprehend that a holistic approach, including lifestyle changes, is crucial for successful obesity treatment and long-term health benefits.

2. What instructions should the nurse give to a patient with cervical cancer who is planned to receive external-beam radiation to prevent complications from the effects of the radiation?

• A. Test stools for the presence of blood.
• B. Maintain a low-residue, high-fiber diet.
• C. Clean the perianal area carefully after every bowel movement.
• D. Inspect the mouth and throat daily for signs of thrush.

Correct answer: C

Rationale: When a patient with cervical cancer is receiving external-beam radiation, the radiation to the abdomen can affect organs in its path, such as the bowel, leading to complications like frequent diarrhea. Cleaning the perianal area carefully after each bowel movement is crucial to decrease the risk of skin breakdown and infection. Testing stools for blood is not necessary since inflammation associated with radiation may lead to occult blood in stools. Maintaining a low-residue diet is actually recommended to prevent bowel irritation. Radiation to the abdomen does not cause stomatitis, so inspecting the mouth and throat for thrush is not directly related to the effects of external-beam radiation in this context.

3. The healthcare provider is caring for a patient who is taking warfarin (Coumadin). Which laboratory value should the healthcare provider monitor closely?

• A. Platelet count.
• B. Prothrombin time (PT).
• C. Hemoglobin level.
• D. White blood cell count.

Correct answer: B

Rationale: Corrected Rationale: When caring for a patient on warfarin, monitoring prothrombin time (PT) is crucial. PT helps assess the blood's ability to clot properly, ensuring the patient maintains therapeutic anticoagulation levels while minimizing bleeding risks. Platelet count (Choice A) is important but not the most critical for warfarin therapy. Hemoglobin level (Choice C) and white blood cell count (Choice D) are not directly related to monitoring the effects of warfarin.

4. What health promotion teaching should prioritize to prevent drug-induced hepatitis?

• A. Finish all prescribed courses of antibiotics, regardless of symptom resolution
• B. Adhere to dosing recommendations of over-the-counter analgesics
• C. Ensure that expired medications are disposed of safely
• D. Ensure that pharmacists regularly review drug regimens for potential interactions

Correct answer: B

Rationale: Adhering to dosing recommendations of over-the-counter analgesics is crucial in preventing drug-induced hepatitis. Overdosing on analgesics can lead to liver damage, making it essential to follow the recommended dosages to reduce the risk of hepatotoxicity.

5. A client with schizophrenia is prescribed haloperidol (Haldol). The nurse should monitor the client for which potential side effect?

• A. Tardive dyskinesia.
• B. Orthostatic hypotension.
• C. Photosensitivity.
• D. Hyperglycemia.

Correct answer: A

Rationale: The correct answer is A: Tardive dyskinesia. Haloperidol (Haldol) is an antipsychotic medication that can lead to tardive dyskinesia, a side effect characterized by involuntary, repetitive movements of the face and body. Monitoring for this side effect is crucial to provide timely interventions and prevent further complications.

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