Nursing Elites

1. A nurse is caring for a client who is receiving treatment with vincristine. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Neurotoxicity
• C. Neutropenia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for symptoms such as peripheral neuropathy, muscle weakness, and tingling sensations is crucial. Choices A, C, and D are incorrect because hyperkalemia, neutropenia, and bradycardia are not typically associated with vincristine therapy.

2. A client with cirrhosis is about to receive a dose of lactulose. The client questions the need for the medication, stating they are not constipated. The nurse should explain that lactulose is used in cirrhosis to reduce levels of which component in the bloodstream?

• A. Glucose
• B. Ammonia
• C. Potassium
• D. Bicarbonate

Correct answer: B

Rationale: Lactulose is administered to clients with cirrhosis to lower blood ammonia levels, thus aiding in the prevention of hepatic encephalopathy. Elevated ammonia levels in cirrhosis can lead to cognitive impairment and hepatic encephalopathy. Therefore, the correct answer is B (Ammonia). Glucose (Choice A) is not the component targeted by lactulose in cirrhosis. Potassium (Choice C) and Bicarbonate (Choice D) are not directly affected by lactulose administration in cirrhosis.

3. A client who is receiving combination chemotherapy is exhibiting a temperature of 38.1°C (100.6°F). Which of the following findings should the nurse identify as an indication of an oncologic emergency?

• A. Dry oral mucous membranes
• B. Nausea and vomiting
• C. Temperature of 38.1°C (100.6°F)
• D. Anorexia

Correct answer: C

Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients undergoing chemotherapy due to the heightened risk of sepsis in immunocompromised individuals. Immediate assessment and intervention are crucial to prevent severe complications. Dry oral mucous membranes, nausea and vomiting, and anorexia are common side effects of chemotherapy but are not specific indicators of an oncologic emergency like a fever in this setting.

4. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)

• A. Thrombocyte count.
• B. Hematocrit.
• C. Amylase.
• D. Liver function tests.

Correct answer: A

Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.

5. A client is being discharged with a new prescription for Metronidazole. Which of the following instructions should the nurse include?

• A. Avoid drinking alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Avoid dairy products while taking this medication.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Consuming alcohol with Metronidazole can lead to a disulfiram-like reaction, causing symptoms such as nausea, vomiting, and flushing. It is crucial to advise clients to abstain from alcohol during the course of treatment to prevent adverse reactions and ensure the effectiveness of the medication.

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