Nursing Elites

1. A client with breast cancer is receiving cyclophosphamide. Which of the following findings should the nurse monitor?

• A. Hypertension
• B. Hyperglycemia
• C. Ototoxicity
• D. Hemorrhagic cystitis

Correct answer: D

Rationale: The nurse should monitor the client for hemorrhagic cystitis when receiving cyclophosphamide due to its potential to cause bladder irritation and lead to this serious adverse effect. It is essential to assess for symptoms such as hematuria, dysuria, and flank pain. Monitoring for hypertension, hyperglycemia, and ototoxicity is not directly related to the side effects of cyclophosphamide.

2. A client is taking oral Oxycodone and Ibuprofen in recommended doses. 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: When Oxycodone, a narcotic analgesic, and Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), are taken together, they work synergistically to enhance the pain-relieving effects of both medications. These drugs act through different mechanisms, leading to a combined analgesic effect that is more effective than when used alone. Therefore, the interaction between Oxycodone and Ibuprofen results in an increase in the expected therapeutic effect of both medications.

3. When educating a client with a new prescription for Omeprazole to manage GERD, which of the following information should the nurse include?

• A. Take the medication before meals.
• B. You may need to take this medication for a long time.
• C. Increase your intake of vitamin C while taking this medication.
• D. Expect immediate relief of symptoms.

Correct answer: A

Rationale: The correct answer is to take the medication before meals. Omeprazole should be taken before meals to ensure its effectiveness in reducing stomach acid production. This timing allows the medication to work on reducing acid secretion when the stomach is most actively producing it, leading to better control of symptoms. Choice B is incorrect because not all patients with GERD need to take Omeprazole for the rest of their lives; the duration of treatment varies. Choice C is incorrect as there is no specific recommendation to increase vitamin C intake while taking Omeprazole. Choice D is incorrect because Omeprazole may take a few days to start providing symptom relief, so immediate relief should not be expected.

4. A client has a new prescription for lisinopril. Which of the following findings should the nurse monitor as an adverse effect of this medication?

• A. Cough
• B. Hyperglycemia
• C. Headache
• D. Dry mouth

Correct answer: A

Rationale: A common adverse effect of lisinopril is a persistent dry cough. Lisinopril is an ACE inhibitor that can cause irritation in the respiratory tract, leading to a cough. Monitoring for a persistent cough is essential as it may indicate a serious adverse effect that requires medical attention. Hyperglycemia (Choice B) is not a common adverse effect of lisinopril. Headache (Choice C) and dry mouth (Choice D) are not typically associated with lisinopril use. Therefore, the correct answer is A: Cough.

5. A healthcare provider is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the healthcare provider use to elicit the child's cooperation?

• A. Offer the child a choice of taking the medication with juice or water
• B. Tell the child it is candy
• C. Hide the medication in a large dish of ice cream
• D. Tell the child they will have a shot instead

Correct answer: A

Rationale: Offering children choices empowers them and can help in gaining cooperation, especially when it comes to taking medications. By providing options like taking the medication with juice or water, the child feels a sense of control and may be more willing to cooperate. This approach respects the child's autonomy and can make the experience more positive for both the child and the healthcare provider. Choices B, C, and D are not ideal strategies as they involve deception or coercion, which can lead to distrust and make the child more resistant to taking medication in the future.

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