Nursing Elites

1. A client has a new prescription for Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the following adverse reactions?

• A. Bone marrow suppression
• B. Pancreatitis
• C. Pancreatitis
• D. Bone marrow suppression

Correct answer: D

Rationale: While bone marrow suppression is not typically associated with Enfuvirtide, a more relevant concern is the risk of severe allergic reactions such as anaphylaxis. Enfuvirtide, an HIV fusion inhibitor, can cause local injection site reactions and systemic allergic responses. Monitoring for signs of allergic reactions, such as rash, fever, and difficulty breathing, is crucial to ensure the client's safety.

2. A client has a new prescription for Metoprolol to treat hypertension. Which of the following instructions should the nurse include?

• A. Stop taking the medication if your heart rate is below 70/min.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Limit your sodium intake while taking this medication.

Correct answer: C

Rationale: The correct instruction for a client taking Metoprolol, a medication used to treat hypertension, is to avoid sudden changes in position. Metoprolol can cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down to standing up, leading to dizziness and falls. By advising the client to change positions slowly, the nurse helps prevent these adverse effects and promotes safety.

3. A client with heart failure is prescribed digoxin. Which statement by the client indicates an adverse effect of the medication?

• A. I can walk a mile a day.
• B. I've had a backache for several days.
• C. I am urinating more frequently.
• D. I feel nauseated and have no appetite.

Correct answer: D

Rationale: Nausea and loss of appetite are common early signs of digoxin toxicity, indicating an adverse effect of the medication. These symptoms should be reported to the healthcare provider immediately for further evaluation and management.

4. A healthcare provider is providing discharge instructions to a client who is prescribed Prednisone. Which of the following dietary instructions should the healthcare provider include?

• 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: The correct answer is to increase the intake of potassium-rich foods (Choice A). Prednisone can cause potassium depletion, so clients should increase their intake of foods such as bananas, oranges, and spinach. Potassium-rich foods help maintain electrolyte balance and prevent complications associated with low potassium levels, such as muscle weakness and irregular heartbeats. Choices B, C, and D are incorrect because increasing dairy products (Choice B) or avoiding foods high in vitamin K (Choice C) are not specifically related to Prednisone therapy. Decreasing protein intake (Choice D) is also not necessary in this case.

5. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?

• A. Uroprotectant agent, such as mesna
• B. Opioid, such as morphine
• C. Loop diuretic, such as furosemide
• D. H1 receptor antagonist, such as diphenhydramine

Correct answer: A

Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.

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