Nursing Elites

1. A client has been prescribed Methotrexate to treat Rheumatoid Arthritis. Which of the following instructions should the nurse provide?

• A. Take this medication with food to prevent nausea.
• B. Avoid alcohol while taking this medication.
• C. Wear sunscreen when outdoors while taking this medication.
• D. Take this medication on an empty stomach.

Correct answer: B

Rationale: Methotrexate is hepatotoxic, and avoiding alcohol is crucial to prevent liver damage. However, Option A (Take this medication with food to prevent nausea) could also be correct, as Methotrexate commonly causes nausea, and taking it with food can help alleviate this side effect. However, the most important instruction is to avoid alcohol due to the risk of liver toxicity.

2. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler before using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone) for asthma control, the beta2-agonist should be administered first. Administering the beta2-agonist before the glucocorticoid helps promote bronchodilation and enhances the absorption of the glucocorticoid, maximizing its effectiveness in the lungs. Choice A is incorrect because albuterol is usually taken as needed for quick relief of asthma symptoms and not necessarily at the same time each day. Choice C is incorrect as beclomethasone is a controller medication used for long-term asthma management, not for acute episodes. Choice D is incorrect as shaking the beclomethasone inhaler before use helps ensure proper medication dispersion for effective inhalation.

3. A client asks the nurse how Rituximab works, which the client is receiving to treat Non-Hodgkin's Leukemia. Which of the following should the nurse include?

• A. Blocks hormone receptors
• B. Increases immune response
• C. Binds with specific antigens on tumor cells
• D. Stops DNA replication during cell division

Correct answer: C

Rationale: Rituximab is a monoclonal antibody that binds with specific antigens on B-lymphocytes, leading to the destruction of cancer cells. In the context of Non-Hodgkin's Leukemia, Rituximab targets and destroys cancerous B-lymphocytes, which helps in treating the disease. Choices A, B, and D are incorrect. Rituximab does not block hormone receptors, increase immune response, or stop DNA replication during cell division. The primary mode of action of Rituximab is its binding with specific antigens on tumor cells, specifically B-lymphocytes, to elicit an immune response against cancerous cells.

4. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

• A. One
• B. Two
• C. Three
• D. Four

Correct answer: A

Rationale: Phenobarbital has a long half-life of 4 days, meaning it remains at therapeutic levels in the body for an extended period. Due to this prolonged duration of action, the nurse should expect to administer phenobarbital once a day to maintain therapeutic levels and effectiveness. Administering it more than once a day would lead to unnecessary dosing and potential adverse effects as the medication remains active in the body for an extended period.

5. A healthcare professional is preparing to administer IV Vancomycin to a client who has a systemic infection. Which of the following actions should the healthcare professional take?

• A. Administer the medication rapidly over 15 minutes.
• B. Monitor the client for hypertension during infusion.
• C. Administer a test dose before the full dose.
• D. Monitor the client for Red Man Syndrome.

Correct answer: D

Rationale: The correct action for the healthcare professional is to monitor the client for Red Man Syndrome. Red Man Syndrome is a common adverse reaction to Vancomycin characterized by flushing, rash, and hypotension. It is important to monitor the client for these symptoms to intervene promptly if they occur.

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