Nursing Elites

1. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?

• A. Assess for bone pain.
• B. Assess for right lower quadrant pain.
• C. Auscultate for crackles in the bases of the lungs.
• D. Auscultate the chest to listen for a heart murmur.

Correct answer: A

Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.

2. A healthcare professional is preparing to administer Spironolactone to a client. Which of the following laboratory results should the professional review before administering this medication?

• A. Serum potassium.
• B. Serum sodium.
• C. Serum chloride.
• D. Serum calcium.

Correct answer: A

Rationale: When administering Spironolactone, it is essential to monitor the client's serum potassium levels because Spironolactone is a potassium-sparing diuretic. Monitoring potassium levels helps to detect hyperkalemia, a potential adverse effect of the medication.

3. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

4. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

• A. Swallow tablets on an empty stomach with plenty of water.
• B. Watch for skin rash and redness when applying calcitonin-salmon topically.
• C. Mix the liquid medication with juice and take it after meals.
• D. Alternate nostrils each time calcitonin-salmon is inhaled.

Correct answer: D

Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. To ensure optimal absorption, the client should alternate nostrils daily when inhaling the medication. This practice helps prevent irritation and promotes consistent drug delivery through both nostrils. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed as a tablet, applied topically, or mixed with juice; it is usually administered intranasally.

5. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?

• A. Stop the infusion.
• B. Call the provider.
• C. Elevate the head of the bed.
• D. Auscultate breath sounds.

Correct answer: A

Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.

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