Nursing Elites

1. A client is prescribed gentamicin for an infection. Which finding indicates a potential adverse reaction to the medication?

• A. Blood pressure 160/90 mm Hg
• B. Presence of red blood cells in the urine
• C. Urine output of 35 mL/hr
• D. Respiratory rate of 22/min

Correct answer: B

Rationale: The presence of red blood cells in the urine is a significant finding that can indicate nephrotoxicity, a potential adverse effect of gentamicin. Nephrotoxicity can lead to kidney damage, and monitoring for this adverse reaction is crucial during gentamicin therapy. Elevated blood pressure (Choice A) is not typically associated with gentamicin adverse reactions. Decreased urine output (Choice C) may suggest kidney impairment but is not as specific as the presence of red blood cells in the urine. Respiratory rate (Choice D) is not directly related to potential adverse reactions to gentamicin.

2. A client has a new prescription for rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The nurse should instruct the client to report fever. Fever can be an indication of an infection, a potential complication of rituximab therapy. Monitoring and reporting fever promptly can help in early intervention to prevent further complications. Dizziness, urinary frequency, and dry mouth are not typically associated with rituximab therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings to report in this scenario.

3. A client has a new prescription for rituximab. Which of the following findings should the nurse instruct the client to report?

• A. Dizziness
• B. Fever
• C. Urinary frequency
• D. Dry mouth

Correct answer: B

Rationale: The correct answer is B: Fever. The nurse should instruct the client to report fever as it can be an indication of an infection, which is a potential complication of rituximab therapy. Monitoring for fever is crucial to detect early signs of infection and prevent complications. Dizziness (choice A), urinary frequency (choice C), and dry mouth (choice D) are not typically associated with rituximab therapy and are not the primary concerns that the nurse needs to address with the client.

4. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?

• A. Brush and floss your teeth regularly.
• B. Avoid drinking grapefruit juice.
• C. Take this medication on an empty stomach.
• D. Increase your intake of calcium-rich foods.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.

5. A client has a new prescription for Cyanocobalamin (Vitamin B12) injections. Which of the following client statements indicates an understanding of the teaching?

• A. I will need to take this medication for the rest of my life.
• B. I will stop taking the medication when my symptoms improve.
• C. I should take this medication with food.
• D. I will need to avoid green, leafy vegetables while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Clients with pernicious anemia or other causes of vitamin B12 deficiency may need to take cyanocobalamin for life to prevent deficiency. It is a lifelong treatment in many cases to maintain adequate B12 levels. Choice B is incorrect because stopping the medication when symptoms improve may lead to a relapse of the deficiency. Choice C is incorrect as cyanocobalamin injections are usually administered on an empty stomach. Choice D is incorrect as there is no need to avoid green, leafy vegetables while taking cyanocobalamin; in fact, these vegetables are good dietary sources of vitamin B12.

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