Nursing Elites

1. A client is receiving treatment with etoposide. Which of the following findings should the nurse monitor?

• A. Hypotension
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypertension

Correct answer: A

Rationale: Etoposide, a chemotherapeutic agent, commonly causes hypotension as an adverse effect. It is crucial for the nurse to monitor the client for signs of hypotension, such as dizziness, lightheadedness, or a drop in blood pressure, to promptly intervene and prevent complications.

2. A healthcare professional is educating a client who has a new prescription for Vitamin B12 injections. Which of the following statements should the healthcare professional include?

• A. Take the medication with a full glass of water.
• B. You will need to take this medication for the rest of your life.
• C. Expect a metallic taste in your mouth.
• D. Avoid consuming dairy products.

Correct answer: B

Rationale: The correct answer is B: 'You will need to take this medication for the rest of your life.' Clients with conditions like pernicious anemia or other causes of vitamin B12 deficiency may require lifelong cyanocobalamin supplementation to prevent deficiency. This is because their bodies are unable to absorb B12 from dietary sources adequately, necessitating ongoing injections to maintain optimal B12 levels. Choices A, C, and D are incorrect. A full glass of water is not necessary for Vitamin B12 injections. Metallic taste in the mouth is not a common side effect of Vitamin B12 injections, and there is no need to avoid consuming dairy products specifically in relation to Vitamin B12 injections.

3. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Monitor for signs of hyperglycemia.
• C. Avoid drinking grapefruit juice.
• D. Increase your intake of potassium-rich foods.

Correct answer: C

Rationale: The correct answer is to instruct the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication, which can potentiate its effects, potentially causing adverse reactions like hypotension and bradycardia. Choices A, B, and D are incorrect. Taking Verapamil at bedtime is not a specific instruction related to its metabolism or side effects. Monitoring for signs of hyperglycemia is not directly related to Verapamil use. Increasing potassium-rich foods intake is not necessary with Verapamil and could potentially lead to hyperkalemia in some cases.

4. In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?

• A. Calcium gluconate
• B. Sodium bicarbonate
• C. Potassium chloride
• D. Magnesium sulfate

Correct answer: A

Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A). Sodium bicarbonate (Choice B) is not indicated for hypotension related to Verapamil use. Potassium chloride (Choice C) and Magnesium sulfate (Choice D) are not the appropriate medications to address the hypotension in this situation.

5. When preparing to administer IV Acyclovir for Herpes Zoster, what action should the nurse take?

• A. Infuse the medication over 1 hour.
• B. Monitor the client's blood pressure every 15 minutes during infusion.
• C. Administer a stool softener.
• D. Monitor the client's blood glucose level every 4 hours during infusion.

Correct answer: A

Rationale: The correct action for the nurse is to infuse IV Acyclovir over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects, so a slow infusion rate is crucial for patient safety. Monitoring blood pressure, administering a stool softener, or monitoring blood glucose levels are not directly related to the administration of IV Acyclovir for Herpes Zoster.

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